Provider Demographics
NPI:1639267933
Name:HILLSIDE CHILDRENS CENTER
Entity Type:Organization
Organization Name:HILLSIDE CHILDRENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO CORPORATE TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:PERROTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-256-7867
Mailing Address - Street 1:PO BOX 10231
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-5231
Mailing Address - Country:US
Mailing Address - Phone:585-654-1418
Mailing Address - Fax:585-654-1450
Practice Address - Street 1:1183 MONROE AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-256-7500
Practice Address - Fax:585-256-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00353219Medicaid
NY02205865Medicaid
NY02711580Medicaid
NY01999540Medicaid
NY00727573Medicaid
NY01934409Medicaid
NY02247212Medicaid
P0120059HSOtherEXCELLUS
NY02553708Medicaid
NY01421085Medicaid
NY02494719Medicaid
NY00969333Medicaid
NY01405729Medicaid