Provider Demographics
NPI:1396917654
Name:RICHMOND CHILDREN'S CENTER, INC
Entity type:Organization
Organization Name:RICHMOND CHILDREN'S CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-471-4141
Mailing Address - Street 1:14 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2915
Mailing Address - Country:US
Mailing Address - Phone:914-576-7742
Mailing Address - Fax:914-632-7759
Practice Address - Street 1:14 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2915
Practice Address - Country:US
Practice Address - Phone:914-576-7742
Practice Address - Fax:914-632-7759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7671442315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01460517Medicaid