Organization
RIVER HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MASTALER PRESIDENT (CHIEF EXECUTIVE OFFICIER)
(315) 482-2511
Entity
Organization
Contact information
Practice address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
(315) 482-2511
Mailing address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
32482
NY
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73641825022
HPSA
NY
01
—
8503001A
OFFICE OF MENTAL HEALTH
NY
Enumeration date
01/23/2017
Last updated
09/30/2020
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