Provider Demographics
NPI:1609209295
Name:ASTOR HEADSTART
Entity Type:Organization
Organization Name:ASTOR HEADSTART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:RANDIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GERENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-765-1345
Mailing Address - Street 1:101 TOMPKINS TER
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1608
Mailing Address - Country:US
Mailing Address - Phone:845-765-1345
Mailing Address - Fax:
Practice Address - Street 1:6339 MILL ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1427
Practice Address - Country:US
Practice Address - Phone:845-838-9904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284778-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency