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Organization
CHILDREN'S HOME OF JEFFERSON COUNTY
Active
Organization
CHILDREN'S HOME OF JEFFERSON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LYNN MONNAT LMHC (PRESIDENT AND CEO)
(315) 777-9747
Entity
Organization
Contact information
Practice address
1704 STATE STREET, WATERTOWN, NY 13601
(315) 788-7430
(315) 785-5637
Mailing address
PO BOX 6550, WATERTOWN, NY 13601-6550
(315) 788-7430
(315) 785-5637
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
00009545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00487210
—
NY
Enumeration date
02/12/2007
Last updated
07/08/2024
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