Provider Demographics
NPI:1427025337
Name:FISHKILL HRC-FFC
Entity Type:Organization
Organization Name:FISHKILL HRC-FFC
Other - Org Name:FISHKILL HEALTH CENTER FOSTER FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE EXECUTIVE OFFICER OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KASIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-831-8704
Mailing Address - Street 1:22 ROBERT R KASIN WAY
Mailing Address - Street 2:FISHKILL HEALTH CENTER FOSTER FAMILY CARE
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508
Mailing Address - Country:US
Mailing Address - Phone:845-831-0165
Mailing Address - Fax:845-831-4192
Practice Address - Street 1:22 ROBERT R KASIN WAY
Practice Address - Street 2:FISHKILL HEALTH CENTER FOSTER FAMILY CARE
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508
Practice Address - Country:US
Practice Address - Phone:845-831-0165
Practice Address - Fax:845-831-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01042057Medicaid