Provider Demographics
NPI:1417011776
Name:PSCH, INC.
Entity Type:Organization
Organization Name:PSCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DANENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-445-4700
Mailing Address - Street 1:22-44 119 STCHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINTBROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11356
Mailing Address - Country:US
Mailing Address - Phone:718-647-7446
Mailing Address - Fax:
Practice Address - Street 1:189 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1405
Practice Address - Country:US
Practice Address - Phone:718-647-7446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01098237320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01098237Medicaid