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SOUTH BEACH ADDICTION TREATMENT CENTER NPI 1922180363


NPI Information

NPI: 1922180363
Provider Name: SOUTH BEACH ADDICTION TREATMENT CENTER
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 33D2041379

Address:
777 SEAVIEW AVENUE
BUILDING A SOUTH BEACH PSYCHIATRIC CENTER
STATEN ISLAND, NY
ZIP 10305
Phone: (718) 667-5202
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SOUTH BEACH ADDICTION TREATMENT CENTER is a community behavioral health in Staten Island, NY. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SOUTH BEACH ADDICTION TREATMENT CENTER NPI is 1922180363. The provider is registered as an organization entity type.

The provider's business location address is:

777 SEAVIEW AVENUE
BUILDING A SOUTH BEACH PSYCHIATRIC CENTER
STATEN ISLAND, NY
ZIP 10305-499
Phone: (718) 667-5202
Fax: (718) 351-1958

The provider's authorized official is Michael A Lawler .
The authorized official title is Associate Commisioner Division Of and has the following contact phone number (518) 457-5312.

The CLIA number assigned to this NPI record is 33D2041379 - comprehensive outpatient rehab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 8/22/2020.


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
1251S00000XCommunity/Behavioral HealthYes

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
101421636MEDICAIDNEW 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.