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General NPI Number Information
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NPI Number | 1720415284
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Entity Type | Organization
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Legal Business Name | HAMILTON COUNTY
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 143 WHITE BIRCH LN
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City | INDIAN LAKE
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State | NY
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Zip | 12842-1424
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Country | US
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Telephone | 518-648-5355
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Fax | 518-648-6437
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Provider Business Mailing Address
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Address Line | 143 WHITE BIRCH LN
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City | INDIAN LAKE
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State | NY
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Zip | 12842-1424
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Country | US
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Telephone | 518-648-5355
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Fax | 518-648-6437
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Authorized Official
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Title or Position | DIRECTOR OF COMMUNITY SERVICES
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Name | MR. ROBERT W KLEPPANG
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Credential | LMSW
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Telephone | 518-648-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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