Provider Demographics
NPI:1336255272
Name:COUNTY OF ROCKLAND
Entity Type:Organization
Organization Name:COUNTY OF ROCKLAND
Other - Org Name:ROCKLAND COUNTY DEPT OF MENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER OF MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITZES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:845-364-2363
Mailing Address - Street 1:50 SANATORIUM RD RM 156
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3555
Mailing Address - Country:US
Mailing Address - Phone:845-364-2378
Mailing Address - Fax:845-364-2381
Practice Address - Street 1:50 SANITORIUM RD
Practice Address - Street 2:BUILDING F-ROOM 240
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3555
Practice Address - Country:US
Practice Address - Phone:845-364-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03000153Medicaid