1700902384 NPI number — ASSOCIATION FOR MENTALLY ILL CHILDREN OF WESTCHESTER, INC.

Table of content: (NPI 1700902384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700902384 NPI number — ASSOCIATION FOR MENTALLY ILL CHILDREN OF WESTCHESTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATION FOR MENTALLY ILL CHILDREN OF WESTCHESTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700902384
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
480 ALBANY POST ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIARCLIFF MANOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-941-9513
Provider Business Mailing Address Fax Number:
914-941-1649

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
480 ALBANY POST ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIARCLIFF MANOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-941-9513
Provider Business Practice Location Address Fax Number:
914-941-1649
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DEVLIN
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
914-941-9513

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00875365 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02179317 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02692446 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01995977 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01739317 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02245765 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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