Provider Demographics
NPI:1861522757
Name:NORTHEAST CENTER FOR YOUTH AND FAMILIES, INC.
Entity type:Organization
Organization Name:NORTHEAST CENTER FOR YOUTH AND FAMILIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-529-7334
Mailing Address - Street 1:203 EAST ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1234
Mailing Address - Country:US
Mailing Address - Phone:413-529-7777
Mailing Address - Fax:413-529-7776
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:413-529-7777
Practice Address - Fax:413-529-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1475675OtherEEC LICENSE #
MA1475325OtherEEC LICENSE #
MA1475778OtherEEC LICENSE #
MA31358OtherBMC HEALTHNET ID
MA1475674OtherEEC LICENSE #
CTCCF GH-89OtherDCF LICENSE #
MA1475703OtherEEC LICENSE #
MA1899791OtherMBHP ID