CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC
NPI 1659389021
Clinic/Center - Rehabilitation, Substance Use Disorder in Watertown, NY
NPI Status: Active since August 03, 2006
Contact Information
611 W MAIN ST
WATERTOWN, NY
ZIP 13601
Phone: (315) 788-1530
Fax: (315) 788-3794
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
About CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC
This page provides the complete NPI Profile along with additional information for Credo Community Center For The Treatment Of Addictions Inc, a provider established in Watertown, New York operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1659389021 assigned on August 2006. The practitioner's primary taxonomy code is 261QR0405X with license number 070310744 (NY). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's other name is Credo Community Center For The Treatment Of Addictions Inc. The authorized official of this NPI record is Jordan Jones (Cfo)
- NPI
- 1659389021
- Provider Legal Name
- THRIVE WELLNESS AND RECOVERY, INC
- Other Organization Name
- CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 611 W MAIN ST WATERTOWN, NY 13601
- Location Phone
- (315) 788-1530
- Location Fax
- (315) 788-3794
- Mailing Address
- 482 BLACK RIVER PKWY WATERTOWN, NY 13601
- Mailing Phone
- (315) 788-1530
- Mailing Fax
- (315) 788-3794
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-03-2006
- Last Update Date
- 07-30-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
- License No.
- 070310744
- License State
- NY
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | (NY) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 02921011 | MEDICAID (05) | NY | |
| 02996752 | MEDICAID (05) | NY |
Reviews for CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 5 | 9 | 3 | 8 | 9 | 0 | 2 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 10 | 9 | 6 | 8 | 18 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 0 + 9 + 6 + 8 + 1 + 8 + 0 + 4 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1659389021 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235957101 | SHEA N GOULD LPN Individual | Licensed Practical Nurse | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1124844956 | ERIKA WALLGREN LMSW Individual | Social Worker | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1225847767 | JOHNDA E MAYNE LMSW Individual | Social Worker | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1649078890 | GABRIELLE PINET Individual | Licensed Practical Nurse | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1023546843 | MRS. AMANDA L CREEL NP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1154211183 | AMBER BOULRICE RN Individual | Registered Nurse | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
| 1578454500 | JESSICA TAYLOR RN Individual | Registered Nurse | 611 W MAIN ST WATERTOWN, NY 13601 (315) 788-1530 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659389021, enumerated in the NPI registry as an "organization" on August 03, 2006
The provider is located at 611 W Main St Watertown, Ny 13601 and the phone number is (315) 788-1530
This medical organization specializes in Clinic/Center with taxonomy code 261QR0405X with a focus in Rehabilitation, Substance Use Disorder
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on August 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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