BRONX LEBANON HOSPITAL LIFE RECOVERY CENTER (NPI# 1578955951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578955951 |
| Entity Type | Organization |
| Organization Name | BRONX LEBANON HOSPITAL LIFE RECOVERY CENTER |
| Practice Address |
1285 Fulton Ave Bronx NY 10456-3401 |
| Mailing Address |
28 Dixon St Tarrytown NY 10591-3304 |
| Practice Telephone | 7185183711 |
| Mailing Telephone | 9144142829 |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |
| Authorized Official Name | MS. DEMETRIA NELSON (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 7185183736 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
0738591 | NY | Ambulatory Health Care Facilities |
| Street Address |
1285 FULTON AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10456-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649341314 | Mariano Delpilar | Social Worker | 1285 Fulton Ave, Life Recovery Center Bronx Lebanon Center, Bronx, NY 10456-3401 | 2006-11-13 |
| 1043660376 | Leigh-ann Borriello | Social Worker | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2016-06-17 |
| 1730558529 | Frank Soto | Counselor | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2015-09-22 |
| 1265801286 | Jose L. Medina | Counselor | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2015-09-21 |
| 1972996080 | Juliette Christine Meyreles | Social Worker | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2015-03-13 |
| 1528460011 | Gina Kijek | Music Therapist | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2014-09-16 |
| 1669887188 | Samantha A. Elhyani | Social Worker | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2014-06-23 |
| 1407151632 | Alicia Michelle Wiggins | Family Medicine | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2011-01-19 |
| 1407094246 | Demetria Nelson | Social Worker | 1285 Fulton Ave, Bronx, NY 10456-3401 | 2009-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778281 | Danielle O'reggio Nurse Practicioner In Family Health P.C. | Nurse Practitioner | 1200 Webster Ave., Bronx, NY 10456 | 2020-04-03 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1174163430 | Emmanuel Guzman | Speech-Language Pathologist | 968 Cauldwell Avenue Rm 307, Bronx, NY 10456 | 2020-01-14 |
| 1154988194 | Arun George Prasad | Student in an Organized Health Care Education/Training Program | 1276 Fulton Avenue, Bronxcare Health System-fulton Divi, Psychiatry Residency, 5th Floor, Bronx, NY 10456 | 2019-05-24 |
| 1619431574 | Soroush Pakniyat-jahromi | Student in an Organized Health Care Education/Training Program | 1276 Fulton Ave. 5th Floor, Bronx, NY 10456 | 2019-01-24 |
| 1548745078 | Danielle Renee O'reggio | Nurse Practitioner | 1210 Webster Ave, Bronx, NY 10456 | 2018-10-01 |
| 1154830537 | Renee Lucette Mills | Counselor | 1011 Washington Avenue, 1st Floor, Bronx, NY 10456 | 2017-09-28 |
| 1487177572 | Webster Urgent Care, P.C. | Clinic/Center | 1210 Webster Avenue, Bronx, NY 10456 | 2017-07-20 |
| 1508395864 | Cheryl Roxann Camp | Counselor | 530 East 169th Street, Apt. 10e, Bronx, NY 10456 | 2017-06-08 |
| 1336683465 | Lorraine Dukes | Health Educator | 778 Forest Ave., P17x, Bronx, NY 10456 | 2016-12-08 |
| Find all providers in zip 10456 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1467076968 | B Well With Brooke LLC | Clinic/Center | 3750 Hudson Manor Ter Apt 1ae, Bronx, NY 10463-1167 | 2020-06-01 |
| 1366988362 | Postgraduate Center for Mental Health | Clinic/Center | 3525 Hull Ave, Bronx, NY 10467-1604 | 2017-01-13 |
| 1629440888 | Samaritan Daytop Village, Inc. | Clinic/Center | 2780 3rd Avenue, Bronx, NY 10455 | 2015-10-28 |
| 1215313184 | Safe Space Therapy Services, Lcsw, Pllc | Clinic/Center | 981 Morris Park Ave, Bronx, NY 10462-3766 | 2015-08-03 |
| 1871974261 | Milestone Psychotherapy, Lcsw, PC | Clinic/Center | 2010 Williamsbridge Rd, 2nd Floor, Bronx, NY 10461-1603 | 2015-06-11 |
| 1023130580 | Our Lady of Mercy Mhc | Clinic/Center | 4401 Bx. Boulevard, Bronx, NY 10470 | 2007-04-04 |
| 1932231107 | Fordham Tremont Cmhc | Clinic/Center | 2021 Grandconcourse Ave, Bronx, NY 10469 | 2007-03-12 |
| 1710022330 | Argus Community, Inc. | Clinic/Center | 402 E 156th St, Bronx, NY 10455-1232 | 2007-02-21 |
| 1962593210 | Yeshiva University | Clinic/Center | 2527 Glebe Avenue, Bronx, NY 10461 | 2006-09-28 |
| Find all providers in BRONX | ||||
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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.