| Risewell Community Services | |
|
456 Waverly Ave Patchogue NY 11772-1586 | |
| (631) 447-6460 | |
| (631) 289-7098 |
| Full Name | Risewell Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 456 Waverly Ave, Patchogue, New York |
| Authorized Official Name and Position | Stephen Mccarthy (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6316695355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Risewell Community Services 1 Farmingdale Route 109 West Babylon NY 11704-6545 Ph: (631) 669-5355 | Risewell Community Services 456 Waverly Ave Patchogue NY 11772-1586 Ph: (631) 447-6460 |
| NPI Number | 1073706032 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073706032 | NPI | - | NPPES |
| 03007701 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 03007701 (New York) | Primary |
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