EATING DISORDER TREATMENT OF NEW YORK, LLC
NPI 1699528950
Clinic/Center - Adolescent and Children Mental Health in Northport, NY

Q: What is Eating Disorder Treatment Of New York, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Active since April 08, 2024

254 BREAD AND CHEESE HOLLOW RD, NORTHPORT, NY 11768(631) 540-0980(631) 967-1667 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 5, 2025, Apr 8, 2024 (2 updates tracked since 2024).

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About Eating Disorder Treatment Of New York, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EATING DISORDER TREATMENT OF NEW YORK, LLC (NPI 1699528950), doing business as Clementine North Shore, is a healthcare organization registered as an adolescent and children mental health in Northport, New York and active in the NPI registry since April 2024. The organization lists Jason Schulz, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1699528950

Entity TypeOrganization

Primary Taxonomy261QM0855X

Legal Business NameEATING DISORDER TREATMENT OF NEW YORK, LLC

Location Address254 BREAD AND CHEESE HOLLOW RDNorthport, NY 11768-2606

Mailing Address6100 Sw 76th StSouth Miami, FL 33143-5002 · (305) 663-1876 · Fax (786) 359-4485

Phone(631) 540-0980

Fax(631) 967-1667

Organization SubpartNo

Authorized OfficialJason SchulzChief Financial Officer · (720) 440-4277

Enumeration DateApril 8, 2024

Last NPPES UpdateJune 5, 20252 updates tracked since enumeration

NPPES CertifiedJune 5, 2025

✔ NPI 1699528950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

254 BREAD AND CHEESE HOLLOW RD, Northport, NY 11768

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Other Names 1

Doing Business AsClementine North Shore

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eating Disorder Treatment Of New York, LLC's NPI number?

The NPI number for Eating Disorder Treatment Of New York, LLC is 1699528950. It was assigned to this organization in the NPPES registry on April 8, 2024. The provider is doing business as Clementine North Shore.

Where is Eating Disorder Treatment Of New York, LLC located?

Eating Disorder Treatment Of New York, LLC is located at 254 Bread And Cheese Hollow Rd, Northport, NY 11768. The listed phone number is (631) 540-0980.

What is Eating Disorder Treatment Of New York, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Eating Disorder Treatment Of New York, LLC was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.