Provider Demographics
NPI:1487841391
Name:NORTHEAST PARENT AND CHILD SOCIETY, INC.
Entity Type:Organization
Organization Name:NORTHEAST PARENT AND CHILD SOCIETY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP OF FINANCE AND ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARINI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CITP
Authorized Official - Phone:518-346-1284
Mailing Address - Street 1:530 FRANKLIN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2011
Mailing Address - Country:US
Mailing Address - Phone:518-346-1284
Mailing Address - Fax:518-372-2869
Practice Address - Street 1:530 FRANKLIN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2011
Practice Address - Country:US
Practice Address - Phone:518-346-1284
Practice Address - Fax:518-372-2869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03A1093322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00784730Medicaid