EATING DISORDER TREATMENT OF NEW YORK, LLC (NPI# 1457825135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457825135 |
| Entity Type | Organization |
| Organization Name | EATING DISORDER TREATMENT OF NEW YORK, LLC |
| Other Organization Name | MONTE NIDO GLEN COVE |
| Practice Address |
1 Saint Andrews Ln Glen Cove NY 11542-2221 |
| Mailing Address |
6100 Sw 76th St South Miami FL 33143-5002 |
| Practice Telephone | 3056631876 |
| Mailing Telephone | 3056631876 |
| Mailing Fax Number | 9144795490 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | MR. MIKE BAGLEY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3056631876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Monte Nido Glen Cove | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023560380 | Eating Disorder Treatment of New York, LLC | Clinic/Center | 233 Pine Rd, Briarcliff Manor, NY 10510-2236 | 2016-11-02 |
| 1891130795 | Eating Disorder Treatment of New York, LLC | Clinic/Center | 117 West 72nd Street, New York, NY 10023-3204 | 2013-05-06 |
| 1588180616 | Eating Disorder Treatment of New York, LLC | Clinic/Center | 222 Bloomingdale Rd, White Plains, NY 10605-1513 | 2017-08-21 |
| 1174928014 | Eating Disorder Treatment of New York, LLC | Community Based Residential Treatment Facility, Mental Illness | 100 S Broadway, Irvington, NY 10533-2128 | 2014-11-04 |
| Street Address |
1 SAINT ANDREWS LN |
| City | GLEN COVE |
| State | NY |
| Zip Code | 11542-2221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104468461 | Yvonne N Valcourt | Registered Nurse | 14 Burns Ave, Glen Cove, NY 11542 | 2019-10-08 |
| 1508419771 | Gregory Stephen Bonistalli | Audiologist | 70 Glen St Ste 100, Glen Cove, NY 11542 | 2019-07-17 |
| 1861954646 | Pulkit Malik | Student in an Organized Health Care Education/Training Program | Northwell Health Glen Cove Hospital, 101 St. Andrews Lane, Glen Cove, NY 11542 | 2019-04-02 |
| 1912498783 | Rays of Light Companion Care Agency LLC | Long Term Care Hospital | 70 Forest Ave # 2g, Glen Cove, NY 11542 | 2018-05-28 |
| 1164978391 | Nithin Kuruvilla | Pharmacist | 421 Glen Cove Road, East Hills, NY 11542 | 2016-08-28 |
| 1063879245 | Kerri A Sujeski | Physician Assistant | 104 Forest Avenue, Glen Cove, NY 11542 | 2016-01-19 |
| 1093110884 | Sherri Meagher | Social Worker | 130 Glen Street, Glen Cove, NY 11542 | 2014-10-23 |
| 1174946537 | Lori Seele | Psychologist | Ridge Drive, Connolly Elementary School, Glen Cove, NY 11542 | 2014-01-21 |
| 1255671210 | Wendy S Grossman | Speech-Language Pathologist | 2 Dosoris Lane, Deasy School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-27 |
| 1033459318 | Kristin Strelec | Social Worker | Seaman & Walnut Roads, Gribbin School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-22 |
| Find all providers in zip 11542 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225697493 | Charles Evans Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 113 Glen Cove Ave, Glen Cove, NY 11542-3438 | 2019-06-11 |
| 1831758325 | Charles Evans Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 9 Highland Rd, Glen Cove, NY 11542-2632 | 2019-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922661784 | Greater Horizons, House Inc. | Community Based Residential Treatment Facility, Mental Illness | 25 Indian Rd Apt 6f, New York, NY 10034-1018 | 2019-04-17 |
| 1013474113 | Hope House On Crotona Park, LLC | Community Based Residential Treatment Facility, Mental Illness | 853 Crotona Park N, Bronx, NY 10460-4701 | 2019-02-25 |
| 1679011530 | Nando Pelusi, Phd | Community Based Residential Treatment Facility, Mental Illness | 305 Hicks Street, 2, Brookyn, NY 11201 | 2017-02-10 |
| 1245684729 | William F Ryan Community Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 138 W 143rd St, New York, NY 10030-1615 | 2016-04-20 |
| 1205280955 | William F Ryan Community Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 22 Convent Ave, New York, NY 10027-2604 | 2016-04-19 |
| 1245602838 | Nyeshia Skipwith | Community Based Residential Treatment Facility, Mental Illness | 37 Titmus Dr, Mastic, NY 11950-2011 | 2015-10-22 |
| 1447663067 | 187 Cottage Avenue Corp | Community Based Residential Treatment Facility, Mental Illness | 187 Cottage Ave, Mount Vernon, NY 10550-1446 | 2014-06-11 |
| 1235542135 | Erin Faryna | Community Based Residential Treatment Facility, Mental Illness | 51 Rossler Ave, Cheektowaga, NY 14206-2409 | 2014-06-09 |
| 1508280504 | Advanced Therapeutic Solutions | Community Based Residential Treatment Facility, Mental Illness | 1731 61st St Apt 4, Brooklyn, NY 11204-2219 | 2014-02-11 |
| 1194163147 | Areivim | Community Based Residential Treatment Facility, Mental Illness | 20 Briarcliff Dr, Monsey, NY 10952 | 2013-06-12 |
| 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.