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Organization
NATURAL DYSTOPIA
Active
Organization
NATURAL DYSTOPIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AKASHIA ROSS (PARTNER/OFFICE MANAGER)
(518) 586-4278
Entity
Organization
Contact information
Practice address
147 RIDGE ST STE 2, GLENS FALLS, NY 12801-3216
(518) 480-7208
(844) 283-6959
Mailing address
5 MOREHOUS DR, TICONDEROGA, NY 12883-1110
(518) 586-4278
(844) 283-6959
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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