SERVICES FOR THE UNDERSERVED (NPI# 1548654932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548654932 |
| Entity Type | Organization |
| Organization Name | SERVICES FOR THE UNDERSERVED |
| Other Organization Name | SERVICES FOR THE UNDERSERVED FOUNTAIN ICF |
| Practice Address |
888 Fountain Ave Suite 221-224 Brooklyn NY 11239-5907 |
| Mailing Address |
305 7th Ave 10th Floor New York NY 10001-6008 |
| Practice Telephone | 7186426034 |
| Mailing Telephone | 9174081642 |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-24 |
| Authorized Official Name | LIN YANG (DIRECTOR - MEDICAID BILLING) |
| Authorized Official Telephone | 9174081642 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7559303 | NY | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Services for the Underserved Fountain ICF | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699150094 | Services for The Underserved | Community/Behavioral Health | 1366 Inwood Ave, Bronx, NY 10452-3203 | 2015-07-27 |
| 1619140241 | Services for The Underserved | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 305 7th Ave, New York, NY 10001-6008 | 2008-04-03 |
| 1437322062 | Services for The Underserved | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 305 7th Ave, New York, NY 10001-6008 | 2008-04-03 |
| 1528231156 | Services for The Underserved | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 305 7th Ave, New York, NY 10001-6008 | 2008-04-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SERVICES FOR THE UNDERSERVED, INC. | 463 Seventh Avenue, 17th Floor, New York, Ny 10018 |
| Street Address |
888 FOUNTAIN AVE SUITE 221-224 |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11239-5907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881733848 | State of New York | Intermediate Care Facility, Mentally Retarded | 888 Fountain Ave, Brooklyn, NY 11208-5907 | 2007-02-06 |
| 1063884914 | Young Adult Institute, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 888 Fountain Ave, Wing 214, Brooklyn, NY 11239-5907 | 2015-10-30 |
| 1629469341 | Young Adult Institute | Intermediate Care Facility, Mentally Retarded | 888 Fountain Ave, Brooklyn, NY 11239-5907 | 2015-02-17 |
| 1609264324 | Lisa Singh | Registered Nurse | 888 Fountain Ave, Brooklyn, NY 11239-5907 | 2015-01-05 |
| 1548488364 | Daniel Despen | Physician Assistant | 888 Fountain Ave, Brooklyn, NY 11208-5997 | 2007-04-24 |
| 1497974208 | Nasreen M Mirza | Family Medicine | 888 Fountain Ave, Brooklyn, NY 11208-5907 | 2007-04-24 |
| 1952529158 | Sharon Rose Abara-palaganas | Family Medicine | 888 Fountain Ave, Brooklyn, NY 11208-5907 | 2007-04-23 |
| 1992929269 | Francis Michael Cavaliere | Contractor | 888 Fountain Ave, Brooklyn, NY 11208-5907 | 2007-04-11 |
| 1720128796 | State of New York | Intermediate Care Facility, Mentally Retarded | 888 Fountain Ave, Brooklyn, NY 11208-5907 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508486259 | Nicole Shari Clarke | Registered Nurse | 185 Arzly Loop, Brooklyn, NY 11239 | 2020-04-23 |
| 1760922348 | Justin Hinds | Licensed Practical Nurse | 1280 Croton Loop Apt. 5g, Brooklyn, NY 11239 | 2017-03-02 |
| 1003293119 | Nichole Atterbury | Licensed Practical Nurse | 200 Bethel Loop Apt11c, Brooklyn, NY 11239 | 2015-04-28 |
| 1770836983 | Micheline Mesidor | Early Intervention Provider Agency | 1201 Pennsylvania Avenue 15 H, Brooklyn, NY 11239 | 2012-10-25 |
| 1336498427 | Samuel Omotoye | Registered Nurse | 1425 Pennsylvanie Avenue, Apt. 16f, Brooklyn, NY 11239 | 2012-09-05 |
| 1659681179 | Leonida Sentillas Griffith | Occupational Therapy Assistant | 1155 Pennsylvania Avenue, Apartment 16d, Brooklyn, NY 11239 | 2010-10-18 |
| 1578887717 | Gail Marie Swayne | Speech-Language Pathologist | 562 Lousiana Avenue, Brooklyn, NY 11239 | 2010-03-17 |
| 1376626994 | Priscila Siagan Zabala | Internal Medicine | 614 Louisiana Ave, Suite I, Brooklyn, NY 11239 | 2006-10-24 |
| 1053402370 | Nabil Raoof | Pediatrics | 1390 Pennsylvania Avenue, Brooklyn, NY 11239 | 2006-09-28 |
| 1306892070 | Willoughby Rehabilitation and Health Care Center LLC | Skilled Nursing Facility | 660 Louisiana Avenue, Brooklyn, NY 11239 | 2006-05-25 |
| Find all providers in zip 11239 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891232179 | Evelyn Douglin Center Spin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 470 Chester St, Brooklyn, NY 11212-5505 | 2017-01-25 |
| 1972049039 | Evelyn Douglin Center Spin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 163 Riverdale Ave, Brooklyn, NY 11212-5579 | 2017-01-13 |
| 1952757429 | Services for The Underserved, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1079 E 34th St, Brooklyn, NY 11210-3441 | 2016-05-13 |
| 1477909943 | Services for The Underserved, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 999 Bushwick Ave, Brooklyn, NY 11221-3735 | 2016-05-13 |
| 1487000956 | Services for The Underserved, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 108 Saint Marks Ave, Brooklyn, NY 11217-2412 | 2016-05-13 |
| 1063868669 | Services for The Underserved, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 109 Decatur St, Brooklyn, NY 11216-2513 | 2016-05-12 |
| 1518298520 | Margaret W Zimmerman | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1103 Lorimer St, Brooklyn, NY 11222-2505 | 2010-01-15 |
| 1427283837 | Dahlia Walks-moore | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5304 Beverley Rd, Brooklyn, NY 11203-5327 | 2009-05-29 |
| 1134399660 | Marie Seide-anglade | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1478 E 87th St, Brooklyn, NY 11236-5138 | 2008-03-12 |
| 1942488283 | Lowell S Miron | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2329 E 22nd St, Brooklyn, NY 11229-4831 | 2008-02-08 |
| Find all providers in BROOKLYN | ||||
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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.