Crestwood Children'S Center

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

CRESTWOOD CHILDREN'S CENTER

Practice address

1183 Monroe Ave
Rochester, NY 14620-1662

Phone

(585) 654-1418

Fax

(585) 654-1450

NPI assigned

Nov 5, 2009

Organization subpart

No

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

Authorized official

Name

Miss Gary Antinone

Title

Accounts Receivable

Phone

(585) 654-1418

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Crestwood Children'S 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.

• Crestwood Children'S Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Rochester, NY
  • NPI 1346576568
  NPD tax ID

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1669709176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201662",
            "telephone_number": "585-654-1418",
            "fax_number": "585-654-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201662",
            "telephone_number": "585-654-1418",
            "fax_number": "585-654-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD CHILDREN'S CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "ANTINONE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "585-654-1418",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00343559",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Creer, RN
• Peter Creigh
• James Andrew Crelly
• Jenna Elizabeth Crelly, LMSW
• Crestwood Children'S Center
• Kelsey Cretekos
• Devin Crevani, DPT
• Veronica Massong Crevelling, M.S.
• Molly Jane Crevier, ACNPC-AG
• Tiffani Crewe-Kujawski, LPN

• Emotionally Disturbed Childrens' Residential Treatment Facility in Rochester, NY
• Providers in Rochester, NY by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.