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NPI Code Detail

MEDICARE: THE CHARLTON SCHOOL

MEDICARE: THE CHARLTON SCHOOL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility00A00390NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336296078
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHARLTON SCHOOL
Provider Business Mailing Address
First Line : PO BOX 47
Second Line :
City : BURNT HILLS
State : NY
Zip : 12027-0047
Country : US
Telephone Number : 518-399-8182
Fax Number : 518-399-8195
Provider Business Practice Location Address
First Line : 322 LAKEHILL RD.
Second Line :
City : BURNT HILLS
State : NY
Zip : 12027-0047
Country : US
Telephone Number : 518-399-8182
Fax Number : 518-399-8195
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DONALD MARSHALL
Credential : L.C.S.W.
Telephone Number : 518-399-8182
Provider Enumeration Date : 01/04/2007
Last Update Date : 08/22/2020

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Directions to “THE CHARLTON SCHOOL ” Practice Location

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