Organization
MHA IN ULSTER COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN L PENDEGAR (CEO)
(845) 336-4747
Entity
Organization
Contact information
Practice address
221 TUYTENBRIDGE RD, LAKE KATRINE, NY 12449-5417
(845) 336-4747
(845) 336-0192
Mailing address
PO BOX 2304, KINGSTON, NY 12402-2304
(845) 336-4747
(845) 336-0192
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01248324
—
NY
05
—
01309966
—
NY
05
—
01405870
—
NY
05
—
02711441
—
NY
Enumeration date
07/05/2007
Last updated
12/03/2015
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