ST. THERESA'S RESIDENCE (NPI# 1275734030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275734030 |
| Entity Type | Organization |
| Organization Name | ST. THERESA'S RESIDENCE |
| Practice Address |
30 S 10th Ave Mt Vernon NY 10550-2907 |
| Practice Telephone | 9146645900 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRUCE ADLER (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 6466334710 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 7482440 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00729617 | 05 |
| Street Address |
30 S 10TH AVE |
| City | MT VERNON |
| State | NY |
| Zip Code | 10550-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487240 | Jacqueline Marshall | Technician | 144 South 2nd Avenue 2c, Mount Vernon, West Chester, NY 10550 | 2020-05-05 |
| 1023529369 | B.t.m. Psychiatric Np Services, Pllc | Nurse Practitioner | 11 W Prospect Ave, 3rd Fl, Suite #5b, Mount Vernon, NY 10550 | 2017-10-13 |
| 1669994174 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 500 E Sanford Blvd, Mount Vernon, NY 10550 | 2017-07-17 |
| 1053869198 | Teresa Turriago I | Social Worker | 487 S. Broadway, Yonkers, New York, NY 10550 | 2016-09-19 |
| 1811340862 | Marcia Samuels Nembhard | Licensed Practical Nurse | 1 Gray Place Apt 4-d, Mount Vernon, NY 10550 | 2016-07-14 |
| 1043665318 | Marshalee Mullings | Registered Nurse | 70 E 4th Street, 2c, Mount Vernon, NY 10550 | 2016-04-25 |
| 1518333228 | Humanities Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 100 Stevens Avenue, Mount Vernon, NY 10550 | 2015-08-17 |
| 1851779458 | Maila Catolico | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-05-14 |
| 1003203266 | Priscilla A. Severe | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-04-24 |
| 1477963254 | Imani Ife Campbell | Licensed Practical Nurse | 323 South 10th Ave, Mt. Vernon, NY 10550 | 2014-05-02 |
| Find all providers in zip 10550 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144348145 | Normal Life of Indiana | Intermediate Care Facility, Mentally Retarded | 1410 Clover St, Mt Vernon, IN 47620 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762665 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 260 W 8th St, Elmira Heights, NY 14903-1502 | 2020-05-21 |
| 1518580851 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 525 Liberty St, Elmira, NY 14904-1517 | 2020-05-21 |
| 1386276541 | United Cerebral Palsy of Nyc Inc | Intermediate Care Facility, Mentally Retarded | 1841-1845 Lacombe Ave, Bronx, NY 10472 | 2020-02-06 |
| 1003447012 | State of New York | Intermediate Care Facility, Mentally Retarded | 8045 Winchester Blvd Bldg 08, Queens Village, NY 11427-2194 | 2020-01-29 |
| 1427696061 | Elderberry Icf | Intermediate Care Facility, Mentally Retarded | 15 Poem Place, Monticello, NY 12701 | 2019-12-13 |
| 1538666052 | Upstate Cerebral Palsy, Inc. | Intermediate Care Facility, Mentally Retarded | 95 Seymour Lane, Westmoreland, NY 13490 | 2018-04-11 |
| 1457857716 | Nysarc, Inc. Cattaraugus-niagara County Chapter | Intermediate Care Facility, Mentally Retarded | 6821 Saunders Settlement Rd, Sanborn, NY 14132-9440 | 2018-04-04 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1962959403 | Linda Burgess | Intermediate Care Facility, Mentally Retarded | 35 E 8th Ave, Gloversville, NY 12078-2229 | 2016-09-01 |
| 1154774727 | Birch Family Services, Inc. | Intermediate Care Facility, Mentally Retarded | 525 W 149th St, New York, NY 10031-3402 | 2016-07-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.