NPIMap

Organization Active NPI

Summit Childrens Residence Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Nyack, NY
National Provider Identifier
1043766595
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
SUMMIT CHILDRENS RESIDENCE CENTER
Practice address
339 N Broadway
Nyack, NY 10960-1522
Phone
(845) 358-7772
NPI assigned
Aug 25, 2016
Last updated
Aug 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Authorized official

Name
Dr. Bruce Goldsmith
Title
Director
Phone
(845) 358-7772

Specialties & licenses 1

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

Addresses

Primary practice location

339 N Broadway
Nyack, NY 10960-1522

Mailing address

339 N Broadway
Nyack, NY 10960-1522
Phone (845) 358-7772

National Provider Directory

National Provider Directory
Tax ID family
Summit Childrens Residence Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Summit School
    • Emotionally Disturbed Childrens' Residential Treatment Facility
    • Nyack, NY
    • NPI 1558536649
    NPD tax ID

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1043766595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 N BROADWAY",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601522",
            "telephone_number": "845-358-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 N BROADWAY",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601522",
            "telephone_number": "845-358-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHILDRENS RESIDENCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "845-358-7772",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.