Organization
EATING DISORDER TREATMENT OF NEW YORK, LLC
Active
Other names
Clementine Hudson Valley
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON SCHULZ (CHIEF FINANCIAL OFFICER)
(720) 440-4277
Entity
Organization
Contact information
Practice address
171 MAIN ST, SOUTH SALEM, NY 10590-1210
(305) 663-1876
(786) 359-4485
Mailing address
6100 SW 76TH ST, SOUTH MIAMI, FL 33143-5002
(305) 663-1876
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/12/2021
Last updated
06/11/2025
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