Provider Demographics
NPI:1679353932
Name:COUNSELING CENTER AT YORKTOWN HEIGHTS, LLC
Entity Type:Organization
Organization Name:COUNSELING CENTER AT YORKTOWN HEIGHTS, LLC
Other - Org Name:SUNRISE DETOX BRENTWOOD
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:USILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-318-4400
Mailing Address - Street 1:141 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-5325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 8TH ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-5325
Practice Address - Country:US
Practice Address - Phone:561-318-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness