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NPI Code Detail

MEDICARE: GREEN CHIMNEYS CHILDRENS SERVICES

MEDICARE: GREEN CHIMNEYS CHILDRENS SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790974327
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREEN CHIMNEYS CHILDRENS SERVICES
Provider Business Mailing Address
First Line : PO BOX 719
Second Line :
City : BREWSTER
State : NY
Zip : 10509-0719
Country : US
Telephone Number : 845-279-2995
Fax Number : 845-279-2714
Provider Business Practice Location Address
First Line : 400 DOANSBURG RD
Second Line :
City : BREWSTER
State : NY
Zip : 10509-5902
Country : US
Telephone Number : 845-279-2995
Fax Number : 845-279-2714
Authorized Official
Title or Position : CFO
Name : MR. ANGELO MATRA
Credential :
Telephone Number : 845-279-2995
Provider Enumeration Date : 10/19/2007
Last Update Date : 10/19/2007

Similar Medicare Providers

1467103903 — VICTORIA HALEY FENNELL LMHC
Practice Location Address:
400 DOANSBURG RD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax:
1346098498 — ALYSSA HENNESSY MSW
Practice Location Address:
400 DOANSBURG RD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax:
1649300658 — AGNES JUHASZ MD
Practice Location Address:
400 DOANSBURG RD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax:
1790983310 — MRS. BETH CAMANN LICSW
Practice Location Address:
400 DOANSBURG RD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax:
1417148842 — MRS. TARA J MCCARTHY RN, FNP, PMHNP
Practice Location Address:
400 DOANSBURG RD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax: 845-279-3024
1871774497 — GREEN CHIMNEYS, CHILDREN'S SERVICES INC.
Practice Location Address:
400 DOANSBURG ROAD
BREWSTER, NY
10509-5902
Practice Phone: 845-279-2995
Practice Fax: 845-279-2714

Directions to “GREEN CHIMNEYS CHILDRENS SERVICES ” Practice Location

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