Organization
187 COTTAGE AVENUE CORP
Active
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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