Provider Demographics
NPI:1215719174
Name:INTEGRITY TREATMENT PARTNERS LLC
Entity type:Organization
Organization Name:INTEGRITY TREATMENT PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GOLDFEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-870-8110
Mailing Address - Street 1:2250 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3109
Mailing Address - Country:US
Mailing Address - Phone:516-200-1669
Mailing Address - Fax:
Practice Address - Street 1:2250 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3109
Practice Address - Country:US
Practice Address - Phone:516-200-1669
Practice Address - Fax:516-665-5168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07976043Medicaid