Provider Demographics
NPI:1225009806
Name:ASTOR SERVICES FOR CHILDREN & FAMILIES
Entity Type:Organization
Organization Name:ASTOR SERVICES FOR CHILDREN & FAMILIES
Other - Org Name:THE ASTOR HOME FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, CSC
Authorized Official - Phone:845-871-1001
Mailing Address - Street 1:6339 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1427
Mailing Address - Country:US
Mailing Address - Phone:845-871-1000
Mailing Address - Fax:845-876-2020
Practice Address - Street 1:6339 MILL ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1427
Practice Address - Country:US
Practice Address - Phone:845-871-1000
Practice Address - Fax:845-876-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7211101YM0800X
251B00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00542567Medicaid