FAGAN RESIDENCE (NPI# 1730209362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730209362 |
| Entity Type | Organization |
| Organization Name | FAGAN RESIDENCE |
| Practice Address |
1504 Depaul St Elmont NY 11003-1900 |
| Practice Telephone | 6316653434 |
| Mailing Telephone | 6316653434 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EDWIN M KENNEDY (CFO) |
| Authorized Official Telephone | 5167337000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6186445 | NY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02245930 | 05 |
| Street Address |
1504 DEPAUL ST |
| City | ELMONT |
| State | NY |
| Zip Code | 11003-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134082 | Remarkable Prosthetics & Orthotics Inc | Orthotist | 1763-1765 Dutch Broadway, Suite 2, Elmont, NY 11003 | 2020-11-06 |
| 1821516089 | Claude Estinville | Licensed Practical Nurse | 158 Elzey Ave, Elmont, NY 11003 | 2017-09-07 |
| 1902341480 | Wisline Fils-siffrant | Licensed Practical Nurse | 39 Sterling Rd, Elmont, NY 11003 | 2016-12-20 |
| 1588019590 | Rose Marie Holmes | Nurse Practitioner | 196 Geldmere Street, Elmont, NY 11003 | 2016-04-27 |
| 1215395819 | Dominique Schlosser | Licensed Practical Nurse | 72 Element Ave, Elmont, NY 11003 | 2016-02-10 |
| 1043675390 | Gerda Lamothe, LLC | Nurse Practitioner | 51 Essex Rd, Elmont, NY 11003 | 2015-12-30 |
| 1013389006 | Dragonfly Cognitive Development and Consulting LLC | Early Intervention Provider Agency | 518 Froelich Place, Elmont, NY 11003 | 2015-10-29 |
| 1659754372 | Lorna Treasure-stanford | Specialist | 288 Doherty Ave, Elmont, NY 11003 | 2015-06-30 |
| 1518348069 | Danna Antoine | Licensed Practical Nurse | 785 Lenore Ln, Elmont, NY 11003 | 2015-06-10 |
| 1578952123 | Ronald Barry Roth | Dentist | 1810 Harriet Street, Elmont, NY 11003 | 2015-01-21 |
| Find all providers in zip 11003 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356976211 | Carolyn Luguya | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 30 Waterside Plz Apt 27g, New York, NY 10010-2626 | 2020-03-11 |
| 1548701154 | Kerry Coons | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 481 Bradford Rd, Schenectady, NY 12304-3721 | 2017-03-15 |
| 1265970461 | Adults & Children W/learning & Dd | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 923 Rainbow Commons Ct, Dix Hills, NY 11746-5638 | 2017-02-08 |
| 1891232179 | Evelyn Douglin Center Spin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 470 Chester St, Brooklyn, NY 11212-5505 | 2017-01-25 |
| 1972049039 | Evelyn Douglin Center Spin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 163 Riverdale Ave, Brooklyn, NY 11212-5579 | 2017-01-13 |
| 1962947846 | Family Residences and Essential Enterprise, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 80-45 Winchester Blvd Building #11, Family Residences and Essential Enterprises, Inc., Queens Village, NY 11427 | 2016-12-30 |
| 1508309857 | Adults & Children W/ Learning & Dd | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 918 Rainbow Commons Ct, Dix Hills, NY 11746-5638 | 2016-11-18 |
| 1962945212 | Adults & Children W/ Learning & Dd | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 921 Rainbow Commons Ct, Dix Hills, NY 11746-5638 | 2016-11-18 |
| 1962944405 | Adults & Children W/ Learning & Dd | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 913 Rainbow Commons Ct, Dix Hills, NY 11746-5638 | 2016-11-15 |
| 1184166274 | Community Mainstreaming Associates, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 920 Rainbow Commons Ct, Dix Hills, NY 11746-5638 | 2016-11-07 |
| 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.