Provider Demographics
NPI:1972829109
Name:YONKERS SERVICE CENTER
Entity Type:Organization
Organization Name:YONKERS SERVICE CENTER
Other - Org Name:ROCKLAND PSYCHIATRIC CENTER -OUT-PATIENT CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMUNITY MENTAL HEALTH NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUBIO-CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-969-0543
Mailing Address - Street 1:2 PARK AVE
Mailing Address - Street 2:NONE
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-3402
Mailing Address - Country:US
Mailing Address - Phone:914-969-0543
Mailing Address - Fax:914-969-3643
Practice Address - Street 1:180 HAWTHORNE AVE
Practice Address - Street 2:#4B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1064
Practice Address - Country:US
Practice Address - Phone:914-969-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY396282261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNONEMedicaid
NYNONEMedicaid
NYNONEMedicare PIN