Healthcare Provider Details

I. General information

NPI: 1598802514
Provider Name (Legal Business Name): TOGETHER FOR YOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 RTE 22
CANAAN NY
12029
US

IV. Provider business mailing address

13640 RTE 22
CANAAN NY
12029
US

V. Phone/Fax

Practice location:
  • Phone: 518-781-4567
  • Fax: 518-781-4566
Mailing address:
  • Phone: 518-781-4567
  • Fax: 518-781-4566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number051010545
License Number StateNY

VIII. Authorized Official

Name: MATTHEW DWYER
Title or Position: DIRECTOR OF REVENUE MANAGEMENT
Credential:
Phone: 518-781-4567