Healthcare Provider Details

I. General information

NPI: 1568909646
Provider Name (Legal Business Name): HUDSON RIVER HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 MILL ST
POUGHKEEPSIE NY
12601-3115
US

IV. Provider business mailing address

313 MILL ST
POUGHKEEPSIE NY
12601-3115
US

V. Phone/Fax

Practice location:
  • Phone: 845-454-5176
  • Fax: 845-485-1641
Mailing address:
  • Phone: 845-454-5176
  • Fax: 845-485-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTA HINES
Title or Position: EXECUTIVE DIRECTOR
Credential: CPA
Phone: 845-417-1218