Provider Demographics
NPI:1407201163
Name:FAMILY RESIDENCES AND ESSENTIAL ENTERPRISE, INC.
Entity Type:Organization
Organization Name:FAMILY RESIDENCES AND ESSENTIAL ENTERPRISE, INC.
Other - Org Name:911 MELVILLE ESTATES ICF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-870-1600
Mailing Address - Street 1:191 SWEET HOLLOW RD
Mailing Address - Street 2:FAMILY RESIDENCES AND ESSENTIAL ENTERPRISE, INC.-911 ME
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1314
Mailing Address - Country:US
Mailing Address - Phone:516-870-1600
Mailing Address - Fax:516-870-1658
Practice Address - Street 1:911 MELVILLE ESTATES
Practice Address - Street 2:FAMILY RESIDENCES AND ESSENTIAL ENTERPRISES, INC.-911 M
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747
Practice Address - Country:US
Practice Address - Phone:516-870-1600
Practice Address - Fax:516-870-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities