Organization
GREEN CHIMNEYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANGELO MATRA (CFO)
(845) 279-2995
Entity
Organization
Contact information
Practice address
400 DOANSBURG ROAD, BREWSTER, NY 10509-0719
(845) 279-2995
(845) 279-2714
Mailing address
PO BOX 719, BREWSTER, NY 10509-0719
(845) 279-2995
(845) 279-2714
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
322D00000X
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01138563
—
NY
Enumeration date
03/02/2007
Last updated
11/06/2014
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