Basic Information
Provider Information
NPI: 1982600680
EntityType: 2
ReplacementNPI:  
OrganizationName: FOUR WINDS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 CROSS RIVER RD
Address2:  
City: KATONAH
State: NY
PostalCode: 105363549
CountryCode: US
TelephoneNumber: 9147638151
FaxNumber:  
Practice Location
Address1: 800 CROSS RIVER RD
Address2:  
City: KATONAH
State: NY
PostalCode: 105363549
CountryCode: US
TelephoneNumber: 9147638151
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/27/2005
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEINSTEIN
AuthorizedOfficialFirstName: BARRY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 9142411239
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: CPA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283Q00000X334020NYY HospitalsPsychiatric Hospital 

ID Information
IDTypeStateIssuerDescription
0027407505NY MEDICAID


Home