CHILDREN'S HOME OF JEFFERSON COUNTY NPI 1053453886

NPI Information

NPI: 1053453886
Provider Name: CHILDREN'S HOME OF JEFFERSON COUNTY
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
1704 STATE STREET
WATERTOWN, NY
ZIP 13601
Phone: (315) 788-7430
Get Directions

CHILDREN'S HOME OF JEFFERSON COUNTY is a residential treatment facility emotionally disturbed children in Watertown, NY. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CHILDREN'S HOME OF JEFFERSON COUNTY NPI is 1053453886. The provider is registered as an organization entity type.

The provider's business location address is:

1704 STATE STREET
WATERTOWN, NY
ZIP 13601
Phone: (315) 788-7430
Fax: (315) 785-5637

The provider's authorized official is Marianne L Dimatteo .
The authorized official title is President And Ceo and has the following contact phone number (315) 788-7430.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 9/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		00009545	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00487210	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »