Organization
ST REGIS MOHAWK TRIBE
Active
Other names
PARTRIDGE HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH TERRANCE (HEALTH DIRECTOR)
(518) 358-3141
Entity
Organization
Contact information
Practice address
412 STATE ROUTE 37, AKWESASNE, NY 13655-3109
(518) 358-3141
(518) 358-2797
Mailing address
412 STATE ROUTE 37, AKWESASNE, NY 13655-3109
(518) 358-3141
(518) 358-2797
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
111211393
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01178234
—
NY
01
—
111211393
OPERATING CERTIFICATE
NY
Enumeration date
09/23/2008
Last updated
03/15/2010
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