Provider Demographics
NPI:1356468540
Name:PROJECT HOSPITALITY INC.
Entity Type:Organization
Organization Name:PROJECT HOSPITALITY INC.
Other - Org Name:PROJECT HOSPITALITY RECOVERY PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, DD
Authorized Official - Phone:718-448-1544
Mailing Address - Street 1:100 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1440
Mailing Address - Country:US
Mailing Address - Phone:718-448-1544
Mailing Address - Fax:718-720-5476
Practice Address - Street 1:14 SLOSSON TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2507
Practice Address - Country:US
Practice Address - Phone:718-273-8409
Practice Address - Fax:718-273-5265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROJECT HOSPITALITY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151110948251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01292593Medicaid