Provider Demographics
NPI:1598882284
Name:PROJECT HOSPITALITY, INC.
Entity Type:Organization
Organization Name:PROJECT HOSPITALITY, INC.
Other - Org Name:
Other - Org Type:
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 1:150C RICHMOND TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1901
Practice Address - Country:US
Practice Address - Phone:718-420-1475
Practice Address - Fax:718-420-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NY8215004A251S00000X, 261QM0801X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01745555Medicaid