Provider Demographics
NPI:1629002969
Name:RIVERDALE MENTAL HEALTH ASSOCIATION INC
Entity Type:Organization
Organization Name:RIVERDALE MENTAL HEALTH ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-796-5300
Mailing Address - Street 1:5676 RIVERDALE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2138
Mailing Address - Country:US
Mailing Address - Phone:718-796-5300
Mailing Address - Fax:718-548-1161
Practice Address - Street 1:642 W 232ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3207
Practice Address - Country:US
Practice Address - Phone:718-224-2900
Practice Address - Fax:718-884-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness