CHILDREN'S HOME OF JEFFERSON COUNTY (NPI# 1053453886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053453886 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HOME OF JEFFERSON COUNTY |
| Practice Address |
1704 State Street Watertown NY 13601 |
| Mailing Address |
Po Box 6550 Watertown NY 13601-6550 |
| Practice Telephone | 3157887430 |
| Practice Fax Number | 3157855637 |
| Mailing Telephone | 3157887430 |
| Mailing Fax Number | 3157855637 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2016-05-04 |
| Authorized Official Name | MRS. KAREN Y RICHMOND (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3157887430 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 00009545 | NY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00487210 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporation Entity | CHILDREN'S HOME OF JEFFERSON COUNTY | , , |
| Street Address |
1704 STATE STREET |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386764611 | Perkins School for The Blind | Residential Treatment Facility, Emotionally Disturbed Children | 175 North Beacon Street, Watertown, MA 02472 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013360361 | Jesse Brand | Residential Treatment Facility, Emotionally Disturbed Children | 60 Forrest Ave, Shirley, NY 11967-1955 | 2016-07-21 |
| 1285040600 | Sean Bedford | Residential Treatment Facility, Emotionally Disturbed Children | 7 Scarlett Ct, Apt 16, New City, NY 10956-5030 | 2014-07-07 |
| 1336575703 | Education Plus Corp | Residential Treatment Facility, Emotionally Disturbed Children | 431 Chapel Hill Rd, Hancock, NY 13783-2248 | 2013-09-17 |
| 1578905212 | Jewish Child Care Association | Residential Treatment Facility, Emotionally Disturbed Children | 671 Osborn St, Brooklyn, NY 11212-5745 | 2013-07-23 |
| 1538419973 | Scott Fierman Services | Residential Treatment Facility, Emotionally Disturbed Children | 31 Ohayo Mountain Rd, Woodstock, NY 12498-1441 | 2012-09-13 |
| 1821374448 | Takenya Tanyette Benbow | Residential Treatment Facility, Emotionally Disturbed Children | 135 West 50th Street 6th Floor, Jewish Board of Family and Children Services, New York, NY 10020 | 2011-10-27 |
| 1720377757 | Lidia Kupiec Lmsw | Residential Treatment Facility, Emotionally Disturbed Children | 178 Bradley Rd, Scarsdale, NY 10583-6343 | 2011-03-30 |
| 1912202482 | Adirondack Leadership Expeditions | Residential Treatment Facility, Emotionally Disturbed Children | 82 Church St, Saranac Lake, NY 12983-1858 | 2011-01-14 |
| 1891016192 | Access: Supports for Living Inc | Residential Treatment Facility, Emotionally Disturbed Children | 87 Little Britain Rd, Newburgh, NY 12550-5113 | 2010-06-21 |
| 1356675151 | Ohel Childrens Home & Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1498 E 34 St, Brooklyn, NY 11234 | 2009-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.