Provider Demographics
NPI:1851707590
Name:ST. CHRISTOPHER'S, INC.
Entity Type:Organization
Organization Name:ST. CHRISTOPHER'S, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-949-0665
Mailing Address - Street 1:1700 OLD ORCHARD STREET
Mailing Address - Street 2:ST. CHRISTOPHER'S, INC
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-2112
Mailing Address - Country:US
Mailing Address - Phone:914-949-0665
Mailing Address - Fax:914-948-2503
Practice Address - Street 1:71 SOUTH BROADWAY
Practice Address - Street 2:ST. CHRISTOPHER'S, INC
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2112
Practice Address - Country:US
Practice Address - Phone:914-949-0665
Practice Address - Fax:914-948-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children