Provider Demographics
NPI:1922413822
Name:GREENBURGH NORTH CASTLE
Entity Type:Organization
Organization Name:GREENBURGH NORTH CASTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF INFORMATION OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-798-7200
Mailing Address - Street 1:1700 OLD ORCHARD STREET
Mailing Address - Street 2:
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:914-231-6748
Practice Address - Street 1:1700 OLD ORCHARD STREET
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-2112
Practice Address - Country:US
Practice Address - Phone:914-949-0665
Practice Address - Fax:914-231-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children