Childrens Home Jefferson Co

NPI 1053453886 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1053453886
Enumeration Date 02/12/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name PEG PEG
Position ACCOUNTANT
Phone (315) 788-7430
Fax (315) 785-5637
Practice Location
1704 STATE ST # 60
WATERTOWN NY, 13601-3102, US
Phone (315) 788-7430
Fax (315) 785-5637
Business Location
1704 STATE ST # 60
WATERTOWN NY, 13601-3102, US
Phone (315) 788-7430
Fax (315) 785-5637
Toxanomy
Taxonomy Code 322D00000X
License State New York
License Number 00009545
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According to our database, Childrens Home Jefferson Co NPI is 1053453886, taxonomy code is 322D00000X and license number is 00009545, license state is located at New York. Childrens Home Jefferson Co physically located at 1704 State St # 60, Watertown NY, 13601-3102. NPI Number 1033115704 has the healthcare provider type.

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1053453886 NPI number is provided on an as is basis without warranty of any kind. 1053453886 is maintained by the National Plan & Provider Enumeration System. The contents of Childrens Home Jefferson Co are for informational purposes only.