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General NPI Number Information
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NPI Number | 1962563353
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Entity Type | Organization
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Legal Business Name | YONKERS RESIDENTIAL CENTER,INC.
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 317 S BROADWAY 1ST FLOOR
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City | YONKERS
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State | NY
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Zip | 10705-2008
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Country | US
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Telephone | 914-476-6502
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Fax | 914-476-2421
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Provider Business Mailing Address
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Address Line | 317 S BROADWAY 1ST FLOOR
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City | YONKERS
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State | NY
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Zip | 10705-2008
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Country | US
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Telephone | 914-476-6502
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Fax | 914-476-2421
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT CORKE
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Credential |
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Telephone | 914-476-6502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | NY
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