Mother Theresa Residence

LBN: Mother Theresa Residence
Mother Theresa Residence is an health care organization with primary practice located at 339 County Line Rd , Amityville NY 11701-2920. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Mother Theresa Residence can be contacted via phone (631) 665-3434, or through Kennedy, Edwin M via phone (516) 733-7000.

Contact Information

Primary practice address
339 County Line Rd Amityville NY 11701-2920
Phone: (631) 665-3434
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kennedy, Edwin M
Phone: (516) 733-7000

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 6186451 New York

Profile Details

NPI number 1780705384
LBN Legal business name Mother Theresa Residence
DBA Doing business as
Authorized official Kennedy, Edwin M
Entity Organization
Organization subpart 1 No
Enumeration date Apr 2nd, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780705384 NPPES
New York MEDICAID 02245930

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