Organization
COUNTY OF ORANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDIRA SMITH (PROGRAM EVALUATION ASSISTANT)
(845) 291-2902
Entity
Organization
Contact information
Practice address
30 HARRIMAN DR, GOSHEN, NY 10924-2410
(845) 291-2600
(845) 291-2628
Mailing address
30 HARRIMAN DR, GOSHEN, NY 10924-2410
(845) 291-2600
(845) 291-2628
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00542503
—
NY
05
—
03004253
—
NY
Enumeration date
01/08/2008
Last updated
07/08/2021
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