Organization
187 COTTAGE AVENUE CORP
Active
Other names
Chester Hill Adult Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ELISHA GRANT JR. (ADMINISTRATOR)
(914) 699-4294
Entity
Organization
Contact information
Practice address
187 COTTAGE AVE, MOUNT VERNON, NY 10550-1446
(914) 664-5046
Mailing address
187 COTTAGE AVE, MOUNT VERNON, NY 10550-1446
(914) 664-5046
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
800-F-986
NY
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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