SAMARITAN DAYTOP VILLAGE INC. NPI 1982878757

NPI Information

NPI: 1982878757
Provider Name: SAMARITAN DAYTOP VILLAGE, INC.

Former Legal Business Name: SAMARITAN VILLAGE, INC.

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
14401 JAMAICA AVE
JAMAICA, NY
ZIP 11435
Phone: (718) 206-1990
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SAMARITAN DAYTOP VILLAGE, INC. is a rehabilitation and substance use disorder clinic center in Jamaica, NY. SAMARITAN DAYTOP VILLAGE, INC. NPI is 1982878757. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Samaritan Village, Inc..

The provider's business location address is:

14401 JAMAICA AVE
JAMAICA, NY
ZIP 11435-601
Phone: (718) 206-1990
Fax: (718) 206-0051

The provider's authorized official is Charles Madray .
The authorized official title is Vp Of Health Services & Community B and has the following contact phone number (718) 206-2000.

The enumeration date for this NPI number is 4/14/2008 and was last updated on 4/29/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	080311278	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	16890	OTHER	NEW YORK	OASAS PROVIDER #
2	PRU #6595	OTHER	NEW YORK	OASAS PROG,REPORT #
3	080311278	OTHER	NEW YORK	OASAS LIC#
4	000245309	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

NPI Synchronization or Removal

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