Provider Demographics
NPI:1972777837
Name:EDWIN GOULD SERVICES FOR CHILDREN & FAMILIES
Entity Type:Organization
Organization Name:EDWIN GOULD SERVICES FOR CHILDREN & FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSI UNIT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-437-3500
Mailing Address - Street 1:40 RECTOR ST
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1705
Mailing Address - Country:US
Mailing Address - Phone:212-437-3500
Mailing Address - Fax:
Practice Address - Street 1:40 RECTOR ST
Practice Address - Street 2:12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1705
Practice Address - Country:US
Practice Address - Phone:212-437-3500
Practice Address - Fax:212-437-3598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00357153Medicaid
NY00342461Medicaid