Provider Demographics
NPI:1598802514
Name:BERKSHIRE FARM CENTER AND SERVICES FOR YOUTH
Entity Type:Organization
Organization Name:BERKSHIRE FARM CENTER AND SERVICES FOR YOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-781-1847
Mailing Address - Street 1:13640 RTE 22
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NY
Mailing Address - Zip Code:12029
Mailing Address - Country:US
Mailing Address - Phone:518-781-4567
Mailing Address - Fax:518-781-4566
Practice Address - Street 1:13640 RTE 22
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:NY
Practice Address - Zip Code:12029
Practice Address - Country:US
Practice Address - Phone:518-781-4567
Practice Address - Fax:518-781-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0510105453245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children