Organization
RISEWELL COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN MCCARTHY CFO (CHIEF FINANCIAL OFFICER)
(631) 669-5355
Entity
Organization
Contact information
Practice address
103 FROST POND RD, GLEN COVE, NY 11542-4008
(516) 674-4251
(516) 674-8453
Mailing address
1 FARMINGDALE ROAD ROUTE 109, WEST BABYLON, NY 11704
(631) 669-5355
(631) 669-1114
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
03007747
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03007747
—
NY
Enumeration date
11/22/2006
Last updated
08/28/2024
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