ELMCOR YOUTH & ADULT ACTIVITIES INC (NPI# 1609909910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609909910 |
| Entity Type | Organization |
| Organization Name | ELMCOR YOUTH & ADULT ACTIVITIES INC |
| Practice Address |
10720 Northern Blvd Corona NY 11368-1236 |
| Mailing Address |
3316 108th St Corona NY 11368-1224 |
| Practice Telephone | 7186510096 |
| Practice Fax Number | 7184573932 |
| Mailing Telephone | 7186510096 |
| Mailing Fax Number | 7184573932 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LIANNA LEE (ACTING EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7186510096 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02772338 | 05 |
| Street Address |
10720 NORTHERN BLVD |
| City | CORONA |
| State | NY |
| Zip Code | 11368-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174994305 | Elmcor Youth and Adult Activities | Substance Abuse Rehabilitation Facility | 10720 Northern Blvd, Corona, NY 11368-1236 | 2015-10-14 |
| 1437412608 | Raymond Dejean Jr. | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-06-21 |
| 1437410404 | Luis M Montero | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-06-06 |
| 1366716615 | Maria Ramirez | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-03-05 |
| 1679846422 | Edgar Vargas | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-02-09 |
| 1760788855 | Robert V Kennedy | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2011-02-07 |
| 1215161765 | Fay Kendall | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2009-05-13 |
| 1295972438 | Olga Treguboff | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2009-01-09 |
| 1073759031 | Michael Quinones | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2008-12-22 |
| 1992941959 | George Acevedo | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2008-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760014039 | Marukh Naeem | Behavioral Analyst | 11119a Roosevelt Ave, Apt 2r, Apt 2r, Corona, NY 11368 | 2020-02-05 |
| 1164072989 | Tonyia Michelle Madison | Counselor | 34-10 108 Street, Corona, Queens, NY 11368 | 2019-09-13 |
| 1962987347 | Sinead Anel Ulloa | Speech-Language Pathologist | 10420 37th Rd, Corona, NY 11368 | 2018-10-01 |
| 1245725779 | Bracha Namdar | Optometrist | 103-06 Roosevelt Ave, Corona, NY 11368 | 2018-06-27 |
| 1548758220 | Karina Elizabeth Carrasco | Specialist | 96- 32 46th Ave, Corona, NY 11368 | 2018-04-27 |
| 1134634033 | Nicole Iuculano | Speech-Language Pathologist | 43-18 97th Place, Corona, NY 11368 | 2017-12-13 |
| 1558880831 | Abenaa Nyame Danquah | Registered Nurse | 55-25 98th Place, Apt 1k, Corona, NY 11368 | 2017-09-18 |
| 1063940443 | Brand Rx Pharmacy Corp | Pharmacy | 97-05 A 57th Avenue, Corona, NY 11368 | 2017-05-30 |
| 1427595909 | Richelle Krish Sumaoy Colmenares | Physical Therapist | 3744 104th St., Corona, New York City, NY 11368 | 2017-01-23 |
| 1235674342 | 39th Avenue Physical Therapy PC | Clinic/Center | 103-18c 39 Ave, Corona, NY 11368 | 2016-12-28 |
| Find all providers in zip 11368 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1093187254 | Samaritan Daytop Village, Inc. | Clinic/Center | 2778 Third Avenue, Bronx, NY 10455 | 2015-10-28 |
| 1588066716 | Care Counseling Center, LLC | Clinic/Center | 214 W 116th St, New York, NY 10026-2494 | 2014-09-18 |
| 1831507573 | Nathaniel Chambers | Clinic/Center | 801 Saint Anns Ave, Bronx, NY 10456-7648 | 2014-07-25 |
| 1508272238 | Trinity of Chemung County | Clinic/Center | 150 Lake St Ste 2, Elmira, NY 14901-3401 | 2014-07-02 |
| 1093074825 | Community Counseling & Mediation | Clinic/Center | 367 E 7th St, Brooklyn, NY 11218-4105 | 2012-05-14 |
| Find all providers with the same taxonomy | ||||
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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.