Provider Demographics
NPI:1184166274
Name:COMMUNITY MAINSTREAMING ASSOCIATES, INC.
Entity type:Organization
Organization Name:COMMUNITY MAINSTREAMING ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-680-3710
Mailing Address - Street 1:1025 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5645
Mailing Address - Country:US
Mailing Address - Phone:516-683-0710
Mailing Address - Fax:
Practice Address - Street 1:920 RAINBOW COMMONS CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5638
Practice Address - Country:US
Practice Address - Phone:516-683-0710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2017-02-01
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