SUFFOLK COUNTY DEPT OF HEALTH SERVICES NPI 1720091945

NPI Information

NPI: 1720091945
Provider Name: SUFFOLK COUNTY DEPT OF HEALTH SERVICES

Doing Business As: BRENTWOOD MENTAL HEALTH CLINIC

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1841 BRENTWOOD RD
BRENTWOOD, NY
ZIP 11717
Phone: (631) 853-7300
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SUFFOLK COUNTY DEPT OF HEALTH SERVICES is a mental health (including community mental health center) clinic center in Brentwood, NY. SUFFOLK COUNTY DEPT OF HEALTH SERVICES NPI is 1720091945. The provider is registered as an organization entity type.
The provider Is Doing Business As Brentwood Mental Health Clinic.

The provider's business location address is:

1841 BRENTWOOD RD
BRENTWOOD, NY
ZIP 11717-625
Phone: (631) 853-7300
Fax: (631) 853-7301

The provider's authorized official is James L Tomarken .
The authorized official title is Commissioner and has the following contact phone number (631) 854-0100.

The CLIA number assigned to this NPI record is 33D2289847 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2006 and was last updated on 10/22/2012.

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	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			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	W02761	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK	BRENTWOOD MH CLINIC
2	00355019	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: 5/5/2024

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