SAMARITAN DAYTOP VILLAGE, INC. (NPI# 1396822839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396822839 |
Entity Type | Organization |
Organization Name | SAMARITAN DAYTOP VILLAGE, INC. |
Other Organization Name | SAMARITAN VILLAGE, INC. |
Practice Address |
13020 89th Rd Richmond Hill NY 11418-3301 |
Mailing Address |
13802 Queens Blvd Briarwood NY 11435-2642 |
Practice Telephone | 7184418913 |
Practice Fax Number | 7188056041 |
Mailing Telephone | 7182062000 |
Mailing Fax Number | 7182064055 |
Enumeration Date | 2006-11-01 |
Last Update Date | 2017-02-02 |
Authorized Official Name | MR. CHARLES MADRAY (VICE PRESIDENT OF HEALTH & COMM) |
Authorized Official Telephone | 7187644249 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | 16890 | NY | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | NYS-OASAS CD OPR.CERT. | 080510352 | 01 |
NY | NYS-OASAS PROVIDER # | 16890 | 01 |
NY | 000245309 | 05 | |
NY | NYS-OASAS PROG.REPORT# | PRU-393 | 01 |
NY | NYDS-DOH LICENSE # | 03A0973 | 01 |
NY | DEA LICENSE | PSO 169587 | 01 |
Other Name | Type Code |
---|---|
Samaritan Village, Inc. | Former Legal Business Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629440888 | Samaritan Daytop Village, Inc. | Clinic/Center | 2780 3rd Avenue, Bronx, NY 10455 | 2015-10-28 |
1093187254 | Samaritan Daytop Village, Inc. | Clinic/Center | 2778 Third Avenue, Bronx, NY 10455 | 2015-10-28 |
1982878757 | Samaritan Daytop Village, Inc. | Clinic/Center | 14401 Jamaica Ave, Jamaica, NY 11435-3601 | 2008-04-14 |
1134240344 | Samaritan Daytop Village, Inc. | Clinic/Center | 620 Route 303, Blauvelt, NY 10913-1170 | 2007-04-03 |
1548381767 | Samaritan Daytop Village, Inc. | Clinic/Center | 1915 Forest Ave, Staten Island, NY 10303-2127 | 2007-04-03 |
1205957297 | Samaritan Daytop Village, Inc. | Clinic/Center | 900 Arnow Avenue, Bronx, NY 10469 | 2007-04-03 |
1831210038 | Samaritan Daytop Village, Inc. | Clinic/Center | 2075 New York Ave, Huntington Station, NY 11746-3238 | 2007-04-03 |
1245272772 | Samaritan Daytop Village, Inc. | Clinic/Center | 368 E 148th St, Bronx, NY 10455-4005 | 2006-06-11 |
1417571639 | Samaritan Daytop Village, Inc. | Clinic/Center | 3050 White Plains Road, Bronx, NY 10467 | 2020-06-03 |
1154795235 | Samaritan Daytop Village, Inc. | Clinic/Center | 250 Grand Concourse, Bronx, NY 10451-5430 | 2015-11-30 |
Street Address |
13020 89TH RD |
City | RICHMOND HILL |
State | NY |
Zip Code | 11418-3301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205453529 | Debra Christiana Brown | Licensed Practical Nurse | 13020 89th Rd, Richmond Hill, NY 11418-3301 | 2020-07-02 |
1174011365 | Carlina Etwaroo | Licensed Practical Nurse | 13020 89th Rd, Richmond Hill, NY 11418-3301 | 2018-04-24 |
1780068510 | Shakema Koger | Licensed Practical Nurse | 13020 89th Rd, Richmond Hill, NY 11418-3301 | 2015-07-10 |
1881000610 | Jacqueline Federici | Registered Nurse | 13020 89th Rd, Richmond Hill, NY 11418-3301 | 2014-07-01 |
1952620262 | Laura Marie Yacino | Registered Nurse | 13020 89th Rd, Richmond Hill, NY 11418-3301 | 2010-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831727494 | Beatrice Oluyemisi Owoeye | Social Worker | Jamaica Medical Center, 8900 Van Wyck Express, Jamaica, NY 11418 | 2020-03-30 |
1023648763 | Annette Karabolli | Specialist | 134-11 Richmond Hills, Queens, NY 11418 | 2020-01-22 |
1447801899 | Elina Babayeva | Occupational Therapist | 85-60 109th Street, Richmond Hill, NY 11418 | 2019-09-26 |
1962979351 | David Gelin | Nurse Practitioner | 134-20 87th Ave, 7f, Richmond Hill, NY 11418 | 2018-10-24 |
1598257339 | Levi Yechiel Grosser | Student in an Organized Health Care Education/Training Program | 134-20 Jamaica Ave, 3rd Floor Axel Building, Jamaica, NY 11418 | 2018-06-06 |
1124519590 | George Jonathan Deannuntis | Pharmacist | 101-21 Jamaica Ave, Richmond Hill, NY 11418 | 2018-05-22 |
1720583545 | Priya Katwala | Student in an Organized Health Care Education/Training Program | 8900 Van Wyvk Expy, Richmond Hill, NY 11418 | 2018-03-25 |
1851817670 | Lawrence Keke Luo | Chiropractor | 105-09 Jamaica Avenue, Richmond Hill, NY 11418 | 2017-08-15 |
1346779162 | Priya Pathadan | Nurse Practitioner | 8900 Vanwyck Expressway, Jamaica Hospital Medical Center -nicu, Jamaica, NY 11418 | 2017-06-06 |
1134654049 | Wqg Physical Therapy PC | Physical Therapist | 87-60 125th St, Richmond Hill, NY 11418 | 2017-04-28 |
Find all providers in zip 11418 |
Taxonomy Code | 324500000X |
Grouping | Residential Treatment Facilities |
Classification | Substance Abuse Rehabilitation Facility |
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
Notes: [7/1/2003: modified title, modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558808618 | Samaritan Daytop Village | Substance Abuse Rehabilitation Facility | 130-15 89th Rd, Richmond Hill, NY 11418 | 2017-01-27 |
1285171348 | Samaritan Daytop Village | Substance Abuse Rehabilitation Facility | 130-20 89th Rd, Richmond Hill, NY 11418 | 2017-01-27 |
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1528609799 | Ebdk At Calverton | Substance Abuse Rehabilitation Facility | 525 Jan Way, Calverton, NY 11933-3005 | 2019-09-30 |
1124679998 | Resource Recovery Center of Orange County LLC | Substance Abuse Rehabilitation Facility | 68 Crystal Run Rd, Middletown, NY 10941-7100 | 2019-09-24 |
1326506064 | Mountainside - Huntington | Substance Abuse Rehabilitation Facility | 141 E Main St Ste 2, Huntington, NY 11743-2850 | 2019-03-12 |
1023589090 | Argus Community, Inc. | Substance Abuse Rehabilitation Facility | 2015-25 Madison Avenue, 4th Floor, New York, NY 10035-1015 | 2018-12-16 |
1578030797 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave, Albany, NY 12206-2408 | 2018-10-25 |
1467949867 | Ocean Recovery East LLC | Substance Abuse Rehabilitation Facility | 113 E 60th St, New York, NY 10022-1939 | 2018-04-20 |
1578050944 | Elev8 Center New York, LLC | Substance Abuse Rehabilitation Facility | 151 W 136th St, New York, NY 10030-2606 | 2018-04-20 |
1518491174 | Aaron Smith | Substance Abuse Rehabilitation Facility | 460 Brielle Ave, Building H, Staten Island, NY 10314 | 2017-04-20 |
1346772019 | Catholic Charities of The Diocese of Rockville Centre | Substance Abuse Rehabilitation Facility | 30 Carlough Rd Ste C, Bohemia, NY 11716-2919 | 2017-03-31 |
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City | RICHMOND HILL |
Zip Code | 11418 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.