Provider Demographics
NPI:1568548162
Name:RICHMOND CHILDREN'S CENTER, INC.
Entity Type:Organization
Organization Name:RICHMOND CHILDREN'S CENTER, INC.
Other - Org Name:RICHMOND COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-471-4141
Mailing Address - Street 1:272 N BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1103
Mailing Address - Country:US
Mailing Address - Phone:914-471-4100
Mailing Address - Fax:914-471-4101
Practice Address - Street 1:919 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1206
Practice Address - Country:US
Practice Address - Phone:914-968-1900
Practice Address - Fax:914-968-5854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7671440315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00332412Medicaid