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EAST HOUSE CORP NPI 1417171562


NPI Information

NPI: 1417171562
Provider Name: EAST HOUSE CORP
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

CLIA Number: 33D2210713

Address:
259 MONROE AVE., STE. 200
ROCHESTER, NY
ZIP 14607
Phone: (585) 238-4800
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EAST HOUSE CORP is a community based residential treatment facility mental illness in Rochester, NY. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. EAST HOUSE CORP NPI is 1417171562. The provider is registered as an organization entity type.

The provider's business location address is:

259 MONROE AVE., STE. 200
ROCHESTER, NY
ZIP 14607-630
Phone: (585) 238-4800
Fax: (585) 238-4899

The provider's authorized official is Gregory Soehner .
The authorized official title is President and has the following contact phone number (585) 238-4823.

The CLIA number assigned to this NPI record is 33D2210713 - other - oasas res program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 9/29/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness6081438NEW YORKNo
2320800000XCommunity Based Residential Treatment Facility, Mental Illness6081430NEW YORKNo
3320800000XCommunity Based Residential Treatment Facility, Mental Illness6081440NEW YORKNo
4320800000XCommunity Based Residential Treatment Facility, Mental Illness6081437NEW YORKNo
5320800000XCommunity Based Residential Treatment Facility, Mental Illness6081436NEW YORKNo
6320800000XCommunity Based Residential Treatment Facility, Mental Illness6081441NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101303662MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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