TULLY HILL
NPI 1629135512
Substance Abuse Rehabilitation Facility in Tully, NY

NPI Status: Active since January 02, 2007

Contact Information

5821 ROUTE 80
TULLY, NY
ZIP 13159
Phone: (315) 696-6114
Fax: (315) 696-8509

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  • Organization
  • Substance Abuse Rehabilitation Facility
  • CLIA Number: 33D2060407
  • CLIA Cert. Type: Ancillary Testing Site in Health Care Center
  • CLIA Exp. Date: 03-26-2027

About TULLY HILL

This page provides the complete NPI Profile along with additional information for Tully Hill, a provider established in Tully, New York operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1629135512 assigned on January 2007. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mrs. Stephanie L Vormwald Cpa (Controller)

NPI
1629135512
Provider Name
TULLY HILL
Entity Type
Organization
Location Address
5821 ROUTE 80 TULLY, NY 13159
Location Phone
(315) 696-6114
Location Fax
(315) 696-8509
Mailing Address
PO BOX 1116 TULLY, NY 13159
Mailing Phone
(315) 696-6114
Mailing Fax
(315) 696-8509
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-02-2007
Last Update Date
04-22-2014
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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

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
Taxonomy Description
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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)
1261QR0405XAmbulatory Health Care Facilities

Clinic/Center
Rehabilitation, Substance Use Disorder

 

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. STEPHANIE L VORMWALD CPA

Authorized Official Title
CONTROLLER
Authorized Official Phone
(315) 696-6114

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
01805967MEDICAID (05)NY 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
33D2060407
Facility Type
Ancillary Testing Site in Health Care Center
Certificate Effective Date
June 11, 2013
Certificate Expiration Date
March 26, 2027
Laboratory Director
DR. GREGORY T. SERFER
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Tully Hill in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629135512, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
1
Doubled → 2
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 1 → 2 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 2 + 3 + 1 + 0 + 5 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1629135512.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
5821 ROUTE 80, BOX 1116
TULLY, NY 13159
Nurse Practitioner (Family)
5821 ROUTE 80
TULLY, NY 13159

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629135512, enumerated as an "organization" on January 02, 2007.

The provider is located at 5821 ROUTE 80 TULLY, NY 13159 and the phone number is (315) 696-6114.

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.