LOWER EASTSIDE SERVICE CENTER INC. NPI 1063637817

NPI Information

NPI: 1063637817
Provider Name: LOWER EASTSIDE SERVICE CENTER, INC.
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 33D2167663

Address:
46 E BROADWAY
NEW YORK, NY
ZIP 10002
Phone: (212) 343-3533
Get Directions

LOWER EASTSIDE SERVICE CENTER, INC. is a methadone clinic center in New York, NY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. LOWER EASTSIDE SERVICE CENTER, INC. NPI is 1063637817. The provider is registered as an organization entity type.

The provider's business location address is:

46 E BROADWAY
NEW YORK, NY
ZIP 10002-803
Phone: (212) 343-3533

The provider's authorized official is Lee Hunter Pavis .
The authorized official title is Vp, Cfo-cio and has the following contact phone number (212) 566-7713.

The CLIA number assigned to this NPI record is 33D2167663 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2007 and was last updated on 9/17/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		00245689	NEW YORK	No
2	251S00000X	Community/Behavioral Health		00245689	NEW YORK	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	00245689	NEW YORK	No
4	261QP2300X	Clinic/Center	Primary Care	00245689	NEW YORK	No
5	261QM2800X	Clinic/Center	Methadone	00245689	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00245689	MEDICAID	NEW 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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