Provider Demographics
NPI:1194827931
Name:FROM THE ASHES, INC.
Entity Type:Organization
Organization Name:FROM THE ASHES, INC.
Other - Org Name:THE KENNETH PETERS CENTER FOR RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:PETERS
Authorized Official - Last Name:RAGNI
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC
Authorized Official - Phone:516-364-2220
Mailing Address - Street 1:6800 JERICHO TPKE
Mailing Address - Street 2:SUITE 122W
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4436
Mailing Address - Country:US
Mailing Address - Phone:516-364-2220
Mailing Address - Fax:516-364-2980
Practice Address - Street 1:6800 JERICHO TPKE
Practice Address - Street 2:SUITE 122W
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4436
Practice Address - Country:US
Practice Address - Phone:516-364-2220
Practice Address - Fax:516-364-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder