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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