Provider Demographics
NPI:1407173198
Name:ROCKLAND PSYCHITATRIC CENTER
Entity Type:Organization
Organization Name:ROCKLAND PSYCHITATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCEUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-359-1000
Mailing Address - Street 1:36 GLEN DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1020
Mailing Address - Country:US
Mailing Address - Phone:914-443-8165
Mailing Address - Fax:
Practice Address - Street 1:36 GLEN DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1020
Practice Address - Country:US
Practice Address - Phone:914-443-8165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014717251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health