Basic Information
| Provider Information | |||||||||
| NPI: | 1982172854 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTHEAST PARENT AND CHILD SOCIETY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186537306 | ||||||||
| FaxNumber: | 5184475234 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186537306 | ||||||||
| FaxNumber: | 5184475234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2018 | ||||||||
| LastUpdateDate: | 11/08/2018 | ||||||||
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| AuthorizedOfficialLastName: | DIMAIO | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5184262648 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.