Provider Demographics
NPI:1659614634
Name:ROCKLAND PSYCHIATRIC CENTER
Entity Type:Organization
Organization Name:ROCKLAND PSYCHIATRIC CENTER
Other - Org Name:ORANGE COUNTY ACT TEAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SERVICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:LEARNED
Authorized Official - Last Name:JOHNSOM
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:845-326-8073
Mailing Address - Street 1:45 ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1912
Mailing Address - Country:US
Mailing Address - Phone:845-326-8073
Mailing Address - Fax:845-326-8003
Practice Address - Street 1:45 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1912
Practice Address - Country:US
Practice Address - Phone:845-326-8073
Practice Address - Fax:845-326-8003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYS OFFICE OF MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087470283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital