Organization · Type 2 NPI

Risewell Community Services

Mental Health Clinic/Center (Including Community Mental Health Center) · Medford, NY

NPI number 1609383389 Active

Practice location

3390 Route 112 Ste B
Medford, NY 11763

Call (631) 512-4092 Map

Fax (631) 698-0137

Mailing address

1 Route 109 Farmingdale Road
West Babylon, NY 11704-6424

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

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NPI record

NPI: 1609383389
Entity type: Organization (Type 2)
Issued: Jan 4, 2018
Last updated: Aug 28, 2024
Status: Active

Other names

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Federation of Organizations for TH Nys Mentally Disabled · former legal business name

Authorized official

Stephen McCarthy, CFO
Chief Financial Officer
(631) 669-5355

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1609383389

Risewell Community Services's National Provider Identifier is 1609383389, issued on Jan 4, 2018. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Medford, NY. The record was last updated on Aug 28, 2024.