Healthcare Provider Details

I. General information

NPI: 1023173820
Provider Name (Legal Business Name): MENTAL HEALTH AMERICA OF DUTCHESS COUNTY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 MANSION ST
POUGHKEEPSIE NY
12601-2623
US

IV. Provider business mailing address

253 MANSION ST
POUGHKEEPSIE NY
12601-2623
US

V. Phone/Fax

Practice location:
  • Phone: 845-473-2500
  • Fax: 845-473-6129
Mailing address:
  • Phone: 845-473-2500
  • Fax: 845-473-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02324885
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MR. ANDREW O'GRADY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 845-473-2500