Organization · NPI-2
187 Cottage Avenue Corp
Community Based Residential Treatment Facility, Mental Illness · Mount Vernon, NY
NPI number1447663067
StatusActive
Last updated in NPPESJun 11, 2014
Details
- NPI
- 1447663067
- Entity type
- Organization (NPI-2)
- Legal business name
- 187 Cottage Avenue Corp
- Organization subpart
- No
- Enumeration date
- Jun 11, 2014
- Last updated
- Jun 11, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | 800-F-986 | NY | Yes |
Other names
- Chester Hill Adult Home (Doing Business As)
Practice location
187 Cottage AveMount Vernon, NY 10550-1446
Phone 914-664-5046
Mailing address
187 Cottage AveMount Vernon, NY 10550-1446
Phone 914-664-5046
Authorized official
David Elisha Grant
Administrator
9146994294
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