Provider Demographics
NPI:1740587724
Name:FAMILY SERVICES OF WESTCHESTER, INC.
Entity Type:Organization
Organization Name:FAMILY SERVICES OF WESTCHESTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-937-2320
Mailing Address - Street 1:1 GATEWAY PLZ
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4674
Mailing Address - Country:US
Mailing Address - Phone:914-937-2320
Mailing Address - Fax:914-937-4452
Practice Address - Street 1:9 W PROSPECT AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2018
Practice Address - Country:US
Practice Address - Phone:914-668-9124
Practice Address - Fax:914-937-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0081L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00546603Medicaid