Provider Demographics
NPI:1427276542
Name:WESTCHESTER ARC
Entity type:Organization
Organization Name:WESTCHESTER ARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOOSAN
Authorized Official - Middle Name:BUSHEHRI
Authorized Official - Last Name:TEHRANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-8330
Mailing Address - Street 1:121 WESTMORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-2323
Mailing Address - Country:US
Mailing Address - Phone:914-428-8330
Mailing Address - Fax:914-285-9539
Practice Address - Street 1:121 WESTMORELAND AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-2323
Practice Address - Country:US
Practice Address - Phone:914-428-8330
Practice Address - Fax:914-285-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00704825Medicaid