Provider Demographics
NPI:1982880860
Name:WESTCHESTER COMMUNITY OPPORTUNITY PROGRAM, INC.
Entity Type:Organization
Organization Name:WESTCHESTER COMMUNITY OPPORTUNITY PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:914-592-5600
Mailing Address - Street 1:2269 SAW MILL RIVER RD
Mailing Address - Street 2:BUILDING #3
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3832
Mailing Address - Country:US
Mailing Address - Phone:914-592-5600
Mailing Address - Fax:914-592-0021
Practice Address - Street 1:54 S 3RD AVE
Practice Address - Street 2:FLOOR #2
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3303
Practice Address - Country:US
Practice Address - Phone:914-664-4042
Practice Address - Fax:914-664-5633
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT VERNON OPEN DOOR PROGRAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01769126Medicaid