Provider Demographics
NPI:1326268681
Name:CHILDREN'S VILLAGE
Entity Type:Organization
Organization Name:CHILDREN'S VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-693-0600
Mailing Address - Street 1:ACCOUNTING DEPARTMENT
Mailing Address - Street 2:ECHO HILLS
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522
Mailing Address - Country:US
Mailing Address - Phone:914-693-0600
Mailing Address - Fax:914-693-8471
Practice Address - Street 1:ECHO HILLS
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522
Practice Address - Country:US
Practice Address - Phone:914-693-0600
Practice Address - Fax:914-693-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00343357Medicaid
NY00801294Medicaid