NPIMap

Organization Active NPI

Green Chimneys Chrildrens Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Brewster, NY
National Provider Identifier
1861673485
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
GREEN CHIMNEYS CHRILDRENS SERVICES
Practice address
400 Doansburg Rd
Brewster, NY 10509-5902
Phone
(845) 279-2995
Fax
(845) 279-2714
NPI assigned
Nov 26, 2007
Last updated
Oct 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
Mr. Angelo Matra
Title
Cfo
Phone
(845) 279-2995

Specialties & licenses 1

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

Addresses

Primary practice location

400 Doansburg Rd
Brewster, NY 10509-5902

Mailing address

PO Box 719
Brewster, NY 10509-0719
Phone (845) 279-2995

Other identifiers 1

IdentifierTypeStateIssuer
00328001MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Green Chimneys4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

400 Doansburg Rd
Brewster, NY 10509
Phone (845) 279-2995

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1861673485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105090719",
            "telephone_number": "845-279-2995",
            "fax_number": "845-279-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DOANSBURG RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105095902",
            "telephone_number": "845-279-2995",
            "fax_number": "845-279-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CHIMNEYS CHRILDRENS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "MATRA",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-279-2995",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "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": "00328001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.