BOBBIE LYNN POLES-FALK (NPI# 1932750247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932750247 |
| Entity Type | Individual |
| Full Name | BOBBIE LYNN POLES-FALK |
| Practice Address |
1 Mustard St Rochester NY 14609-6980 |
| Mailing Address |
16 Woodsmeadow Ln Rochester NY 14623-2746 |
| Practice Telephone | 5856541500 |
| Mailing Telephone | 5856298770 |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
1 MUSTARD ST |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14609-6980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801978044 | Jennifer Enzanna Kimmel | Social Worker | 1 Mustard St, Rochester, NY 14609-6980 | 2006-10-19 |
| 1932710308 | Megan B Smith | Peer Specialist | 1 Mustard St, Rochester, NY 14609-6980 | 2020-08-11 |
| 1033745856 | Jonathan David Weaver | Social Worker | 1 Mustard St, Rochester, NY 14609-6980 | 2020-03-13 |
| 1437784865 | Nancy Williams | Peer Specialist | 1 Mustard St, Rochester, NY 14609-6980 | 2020-03-05 |
| 1417581562 | Cristina Camardo | Counselor | 1 Mustard St, Rochester, NY 14609-6980 | 2020-02-27 |
| 1568002905 | Lyn Dang | Social Worker | 1 Mustard St, Rochester, NY 14609-6980 | 2020-01-14 |
| 1063051845 | Jacqueline Lee Donk | Counselor | 1 Mustard St, Rochester, NY 14609-6980 | 2019-12-27 |
| 1952949265 | Kweli K Sams | Counselor | 1 Mustard St, Rochester, NY 14609-6980 | 2019-12-17 |
| 1205471406 | Anne Marie Siconolfi | Case Manager/Care Coordinator | 1 Mustard St, Rochester, NY 14609-6980 | 2019-11-12 |
| 1245881150 | Julie Marie Falkowski | Peer Specialist | 1 Mustard St, Rochester, NY 14609-6980 | 2019-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928828 | Aundrea Camille Williams | Licensed Practical Nurse | 99 Meaodw Circle, Rochester, NY 14609 | 2020-10-06 |
| 1043836869 | Sharon Ann Reilly | Registered Nurse | 910 North Goodman Street, Suite 1, Rochester, NY 14609 | 2020-06-17 |
| 1235655671 | Tameka Shaunte Parker | Licensed Practical Nurse | 35 Village Way, Rochester, NY 14609 | 2017-08-17 |
| 1851817472 | Mary Ann Dukes | Registered Nurse | 75 Yates Street, Rochester, NY 14609 | 2017-08-15 |
| 1023533064 | Fernando Caumont | Urology | 2615 Culver Rd Ste 100, Rochester, NY 14609 | 2017-08-10 |
| 1083061162 | Teyanee Latavia Harewood | Registered Nurse | 418 Hayward Ave, Rochester, NY 14609 | 2016-05-19 |
| 1164853891 | Sukhminder Kaur Sahansra | Internal Medicine | 335 North Park Drive, Elderone, Rochester, NY 14609 | 2013-12-05 |
| 1952749863 | Nada Jadrovska | Registered Nurse | 79 Eagle Rock Dr, Rochester, NY 14609 | 2013-06-13 |
| 1457602930 | Lynnetta Maria Hollomon | Licensed Practical Nurse | 827 Edgecreek Trail, Rochester, NY 14609 | 2012-09-25 |
| 1568711596 | Anthony L. Jordan Health Corporation | Clinic/Center | 151 Parsells Ave, Jordan Health At Community Place, Rochester, NY 14609 | 2012-09-06 |
| Find all providers in zip 14609 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225365877 | Hillside Children's Center | Residential Treatment Facility, Emotionally Disturbed Children | 1183 Monroe Ave, Rochester, NY 14620-1662 | 2009-11-03 |
| 1407183049 | Hillside Children's Center | Residential Treatment Facility, Emotionally Disturbed Children | 1183 Monroe Ave, Rochester, NY 14620-1662 | 2009-11-03 |
| 1346576568 | Crestwood Children's Center | Residential Treatment Facility, Emotionally Disturbed Children | 1183 Monroe Ave, Rochester, NY 14620-1662 | 2009-10-22 |
| 1285875054 | Hillside Children's Center | Residential Treatment Facility, Emotionally Disturbed Children | 1183 Monroe Avenue, Accounts Receivable, Rochester, NY 14620 | 2009-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013360361 | Jesse Brand | Residential Treatment Facility, Emotionally Disturbed Children | 60 Forrest Ave, Shirley, NY 11967-1955 | 2016-07-21 |
| 1285040600 | Sean Bedford | Residential Treatment Facility, Emotionally Disturbed Children | 7 Scarlett Ct, Apt 16, New City, NY 10956-5030 | 2014-07-07 |
| 1336575703 | Education Plus Corp | Residential Treatment Facility, Emotionally Disturbed Children | 431 Chapel Hill Rd, Hancock, NY 13783-2248 | 2013-09-17 |
| 1578905212 | Jewish Child Care Association | Residential Treatment Facility, Emotionally Disturbed Children | 671 Osborn St, Brooklyn, NY 11212-5745 | 2013-07-23 |
| 1538419973 | Scott Fierman Services | Residential Treatment Facility, Emotionally Disturbed Children | 31 Ohayo Mountain Rd, Woodstock, NY 12498-1441 | 2012-09-13 |
| 1821374448 | Takenya Tanyette Benbow | Residential Treatment Facility, Emotionally Disturbed Children | 135 West 50th Street 6th Floor, Jewish Board of Family and Children Services, New York, NY 10020 | 2011-10-27 |
| 1720377757 | Lidia Kupiec Lmsw | Residential Treatment Facility, Emotionally Disturbed Children | 178 Bradley Rd, Scarsdale, NY 10583-6343 | 2011-03-30 |
| 1912202482 | Adirondack Leadership Expeditions | Residential Treatment Facility, Emotionally Disturbed Children | 82 Church St, Saranac Lake, NY 12983-1858 | 2011-01-14 |
| 1891016192 | Access: Supports for Living Inc | Residential Treatment Facility, Emotionally Disturbed Children | 87 Little Britain Rd, Newburgh, NY 12550-5113 | 2010-06-21 |
| 1356675151 | Ohel Childrens Home & Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1498 E 34 St, Brooklyn, NY 11234 | 2009-09-25 |
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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.