Provider Demographics
NPI:1235325234
Name:ASTOR HOME FOR CHILDREN
Entity Type:Organization
Organization Name:ASTOR HOME FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:INA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-486-2667
Mailing Address - Street 1:13 MOUNT CARMEL PL
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1714
Mailing Address - Country:US
Mailing Address - Phone:845-452-6077
Mailing Address - Fax:845-452-6235
Practice Address - Street 1:13 MOUNT CARMEL PL
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1714
Practice Address - Country:US
Practice Address - Phone:845-452-6077
Practice Address - Fax:845-452-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO328481251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health