Organization
SOUTH SHORE CHILD ASSOCIATION INCORPORATED
Active
Other names
South Shore Child Guidance, South Shore Guidance Center
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE M RICHMAN (REVENUE MANAGEMENT ADMINISTRATOR)
(516) 739-7733
Entity
Organization
Contact information
Practice address
114 CHURCH STREET, FREEPORT, NY 11520-3731
(516) 868-3030
(516) 868-3374
Mailing address
114 CHURCH STREET, FREEPORT, NY 11520-3731
(516) 868-3030
(516) 868-3374
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
160310993
NY
251S00000X
Community/Behavioral Health Agency
080310993
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00336943
—
NY
05
—
03001127
—
NY
01
—
080310993
OASAS OPERATING CERTIFICA
NY
Enumeration date
01/30/2007
Last updated
06/19/2023
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