Organization
MENTAL HEALTH ASSOCIATION IN FULTON AND MONTGOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANINE ANN DYKEMAN M.S. (EXECUTIVE DIRECTOR)
(518) 762-5332
Entity
Organization
Contact information
Practice address
11 MOHAWK PLACE, AMSTERDAM, NY 12010
(518) 842-3717
(518) 842-0228
Mailing address
307-309 MEADOW STREET, JOHNSTOWN, NY 12095
(518) 762-5332
(518) 762-6823
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
R7277431
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01304750
—
NY
05
—
3E7
—
NY
Enumeration date
10/02/2006
Last updated
03/29/2012
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