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Organization
ORANGE COUNTY DEPT OF MENTTAL HEALTH
Active
Organization
ORANGE COUNTY DEPT OF MENTTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R BOLZAN MS (DIRECTOR OF CLINICAL SERVICES)
(845) 291-2608
Entity
Organization
Contact information
Practice address
146 PIKE ST, PORT JERVIS, NY 12771-1808
(845) 858-1456
(845) 858-1459
Mailing address
146 PIKE ST, PORT JERVIS, NY 12771-1808
(845) 858-1456
(845) 858-1459
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
070519
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070519
STATE LICENSE
NY
Enumeration date
05/10/2010
Last updated
05/10/2010
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