Organization Name: | MADISON COUNTY |
NPI Number: | 1689780546 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN L ADAMS (PROGRAM DIRECTOR) |
Mailing Address: | 138 North Court Street Wampsville |
State: | NY US |
Postal Code: | 131630608 |
Phone Number: | 3153662327 |
Fax Number: | 3153662599 |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 07/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 6873100A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |