Healthcare Provider Details

I. General information

NPI: 1982820213
Provider Name (Legal Business Name): MOHAWK OPPORTUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NOTT TERRACE
SCHENECTADY NY
12307
US

IV. Provider business mailing address

201 NOTT TERRACE
SCHENECTADY NY
12307
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-8424
  • Fax: 518-374-8440
Mailing address:
  • Phone: 518-374-8424
  • Fax: 518-374-8440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number7638470A
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number7638430
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number7638434
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number7638432
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number7638435
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number7638431
License Number StateNY

VIII. Authorized Official

Name: MR. JOSEPH GALLAGHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 518-374-8424