Organization
NORTH COUNTRY TRANSITIONAL LIVING SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN RUTH MATHEWS (FINANCE SPECIALIST)
(315) 782-1777
Entity
Organization
Contact information
Practice address
482 CITY CENTER DR, WATERTOWN, NY 13601-2365
(315) 782-1777
(315) 785-8628
Mailing address
482 CITY CENTER DR, WATERTOWN, NY 13601-2365
(315) 782-1777
(315) 785-8628
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01305022
—
NY
05
—
02135582
—
NY
Enumeration date
02/22/2007
Last updated
03/17/2015
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