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General NPI Number Information
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NPI Number | 1811193915
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Entity Type | Organization
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Legal Business Name | ROCKLAND HOSPITAL GUILD, INC.
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 OLD ORANGEBURG RD BLDG. 1 - ROOM 204
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City | ORANGEBURG
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State | NY
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Zip | 10962-1157
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Country | US
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Telephone | 845-680-5422
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Fax | 845-680-5562
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Provider Business Mailing Address
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Address Line | 140 OLD ORANGEBURG RD BLDG. 1 - ROOM 204
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City | ORANGEBURG
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State | NY
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Zip | 10962-1157
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Country | US
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Telephone | 845-680-5422
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Fax | 845-680-5562
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | MS. MARCY CORVALAN
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Credential |
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Telephone | 845-680-5422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 6399431
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License Number State | NY
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