Organization
BERKSHIRE FARM CENTER & SEVICES FOR YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY GIACCHETTA (CEO)
(518) 781-4567
Entity
Organization
Contact information
Practice address
3464 WEBSTER AVE, BRONX, NY 10467
(718) 515-7972
(718) 515-7979
Mailing address
13640 STATE ROUTE 22, CANAAN, NY 12029
(518) 781-4567
(518) 781-0505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
051010545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02497758
—
NY
Enumeration date
08/27/2008
Last updated
08/27/2008
Update your record
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