=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801071600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MENTAL HELATH ASSOCIATION IN ORANGE CO, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2007
-----------------------------------------------------
Last Update Date | 07/08/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 73 COUNTY HIGHWAY 108
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10940-6948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-342-2400
-----------------------------------------------------
Fax | 845-343-9665
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 73 COUNTY HIGHWAY 108
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10940-6948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-342-2400
-----------------------------------------------------
Fax | 845-343-9665
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIR OF FINANCE
-----------------------------------------------------
Name | MS. KATHLEEN MORGAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 845-342-2400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number | N/A
-----------------------------------------------------
License Number State |
-----------------------------------------------------