EBDK AT CALVERTON (NPI# 1528609799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528609799 |
| Entity Type | Organization |
| Organization Name | EBDK AT CALVERTON |
| Other Organization Name | WELLBRIDGE |
| Practice Address |
525 Jan Way Calverton NY 11933-3005 |
| Mailing Address |
67 Clinton Rd Garden City NY 11530-4777 |
| Practice Telephone | 6315085400 |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2020-06-01 |
| Authorized Official Name | ROBERT JAMES LENAHAN (PROJECT MANAGER) |
| Authorized Official Telephone | 6312058699 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Wellbridge | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | EBDK AT CALVERTON, LLC | 300 Jericho Turnpike, Suite 100, Garden City, Ny 11530 |
| Street Address |
525 JAN WAY |
| City | CALVERTON |
| State | NY |
| Zip Code | 11933-3005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679981385 | Peconic Speech Services, P.C. | Speech-Language Pathologist | 305 Edwards Ave, Calverton, NY 11933 | 2014-07-25 |
| 1548549942 | Karlene Leonie Oakley | Registered Nurse | 67 Donna Drive, Baiting Hollow, NY 11933 | 2011-08-16 |
| 1497058036 | Janet Lynn Kantor | Speech-Language Pathologist | 374 Riley Avenue, Riley Avenue School, Calverton, NY 11933 | 2010-12-20 |
| 1346407780 | Eboni T Marshall | Registered Nurse | 32 Wooded Way, Calverton, NY 11933 | 2008-05-22 |
| 1245408038 | Djamshid Shirazian | Pathology | 4603 Middle Country Rd, 12-3 Suny Incubator, Calverton, NY 11933 | 2008-02-14 |
| 1487822375 | Foroozan Mokhtarian | Pathology | Suny Incubator 4603 Middle Country Road, Suite 12-3, Calverton, NY 11933 | 2008-02-14 |
| 1952591380 | Georgina Kathryn Kamide | Registered Nurse | 114 Gregory Way, Calverton, NY 11933 | 2007-08-01 |
| 1609945112 | Lynne Ann Scalzo | Dietitian, Registered | 95 Sunwood Dr, Calverton, NY 11933-1011 | 2006-11-07 |
| 1023217098 | Patricia Marie Kelly | Specialist | 66 Oak Dr, Calverton, NY 11933-1100 | 2007-07-11 |
| 1013471127 | Natalie Nicole Lugo | Massage Therapist | 33 Oak Dr, Baiting Hollow, NY 11933-1106 | 2019-01-23 |
| Find all providers in zip 11933 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992337224 | Council On Addiction Recovery Services, Inc. | Substance Abuse Rehabilitation Facility | 1355 Olean-portville Road, Westons Mills, NY 14788-1476 | 2020-02-05 |
| 1124679998 | Resource Recovery Center of Orange County LLC | Substance Abuse Rehabilitation Facility | 68 Crystal Run Rd, Middletown, NY 10941-7100 | 2019-09-24 |
| 1326506064 | Mountainside - Huntington | Substance Abuse Rehabilitation Facility | 141 E Main St Ste 2, Huntington, NY 11743-2850 | 2019-03-12 |
| 1023589090 | Argus Community, Inc. | Substance Abuse Rehabilitation Facility | 2015-25 Madison Avenue, 4th Floor, New York, NY 10035-1015 | 2018-12-16 |
| 1578030797 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave, Albany, NY 12206-2408 | 2018-10-25 |
| 1467949867 | Ocean Recovery East LLC | Substance Abuse Rehabilitation Facility | 113 E 60th St, New York, NY 10022-1939 | 2018-04-20 |
| 1578050944 | Elev8 Center New York, LLC | Substance Abuse Rehabilitation Facility | 151 W 136th St, New York, NY 10030-2606 | 2018-04-20 |
| 1518491174 | Aaron Smith | Substance Abuse Rehabilitation Facility | 460 Brielle Ave, Building H, Staten Island, NY 10314 | 2017-04-20 |
| 1346772019 | Catholic Charities of The Diocese of Rockville Centre | Substance Abuse Rehabilitation Facility | 30 Carlough Rd Ste C, Bohemia, NY 11716-2919 | 2017-03-31 |
| 1558893479 | Joseph Wilson | Substance Abuse Rehabilitation Facility | 273 Heberton Avenue, Staten Island, NY 10302 | 2017-03-30 |
| 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.