NPIMap

Organization Active NPI

Julia Dyckman Andrus Memorial, Inc.

Doing business as Andrus Children's Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Yonkers, NY
National Provider Identifier
1003991019
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
00A01157 Issued in NY
Legal business name
JULIA DYCKMAN ANDRUS MEMORIAL, INC.
Doing business as
Andrus Children's Center
Practice address
1156 North Broadway
Yonkers, NY 10701-1108
Phone
(914) 965-3700
Fax
(914) 965-3883
NPI assigned
Oct 26, 2006
Last updated
Sep 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Raul T Del Pilar
Title
Interim Ceo
Phone
(914) 965-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 00A01157 NY Primary

Addresses

Primary practice location

1156 North Broadway
Yonkers, NY 10701-1108

Mailing address

1156 North Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700

Other identifiers 1

IdentifierTypeStateIssuer
00745088MedicaidNY

Other names 1

  • Andrus Children's Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Julia Dyckman Andrus Memorial5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1003991019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 NORTH BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108",
            "telephone_number": "914-965-3700",
            "fax_number": "914-965-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 NORTH BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108",
            "telephone_number": "914-965-3700",
            "fax_number": "914-965-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA DYCKMAN ANDRUS MEMORIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "DEL PILAR",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "914-965-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NY",
            "license": "00A01157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00745088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andrus Children's Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andrus Children's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.