Provider Demographics
NPI:1851541015
Name:REALITY HOUSE INC
Entity Type:Organization
Organization Name:REALITY HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-281-6004
Mailing Address - Street 1:8-13 ASTORIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102
Mailing Address - Country:US
Mailing Address - Phone:212-281-6004
Mailing Address - Fax:212-281-7155
Practice Address - Street 1:8-13 ASTORIA BLVD
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:212-281-6004
Practice Address - Fax:212-281-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NY130211685251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03114789Medicaid