Healthcare Provider Details

I. General information

NPI: 1700902384
Provider Name (Legal Business Name): ASSOCIATION FOR MENTALLY ILL CHILDREN OF WESTCHESTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ALBANY POST ROAD
BRIARCLIFF MANOR NY
10510
US

IV. Provider business mailing address

480 ALBANY POST ROAD
BRIARCLIFF MANOR NY
10510
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-9513
  • Fax: 914-941-1649
Mailing address:
  • Phone: 914-941-9513
  • Fax: 914-941-1649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00875365
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 2
Identifier02179317
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 3
Identifier02692446
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 4
Identifier01995977
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 5
Identifier01739317
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 6
Identifier02245765
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MR. CHARLES DEVLIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 914-941-9513