HUDSON MOHAWK RECOVERY CENTER INC (NPI# 1275082562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275082562 |
| Entity Type | Organization |
| Organization Name | HUDSON MOHAWK RECOVERY CENTER INC |
| Practice Address |
1724 5th Ave Troy NY 12180-3541 |
| Practice Telephone | 5182723918 |
| Practice Fax Number | 5182726391 |
| Mailing Telephone | 5182723918 |
| Mailing Fax Number | 5182726391 |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2016-09-27 |
| Authorized Official Name | MRS. MARY DELORY (TROY CLINIC DIRECTOR) |
| Authorized Official Telephone | 5182723918 |
| Authorized Official Credential | CASAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
30911 | NY | Ambulatory Health Care Facilities |
| Street Address |
1724 5TH AVE |
| City | TROY |
| State | NY |
| Zip Code | 12180-3541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851452767 | Hudson Mohawk Recovery Center | Rehabilitation, Substance Use Disorder Unit | 1724 5th Ave, Troy, NY 12180-3320 | 2006-12-13 |
| 1780018200 | Samantha Ste.marie | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-09-03 |
| 1114359007 | Douglas Handy | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-08-02 |
| 1568808087 | Toni M Cochis | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-13 |
| 1174969539 | Lauren Kelly | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-13 |
| 1942645551 | Sarah E Mcclane | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-09 |
| 1457796146 | Roberto C Dimambro | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-08 |
| 1528403102 | Irectorhudson Mohawk Recovery Center | Community/Behavioral Health | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-08 |
| 1114289972 | Mary Ann Laverty | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2012-06-07 |
| 1184832776 | Craig William Stratton | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1568020857 | Shelby Mara Quintal | Counselor | 7 Collins Ave, Troy, NY 12180 | 2019-05-31 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1104354315 | Karen Lynm Vincent | Licensed Practical Nurse | 830 Hoosick Rd Apt 1, Troy, NY 12180 | 2017-06-01 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1205373263 | Tsu Han Poh | Pharmacist | 204 Washington Street, Apt C1, Troy, NY 12180 | 2017-01-27 |
| 1053760546 | Linda Pierre | Religious Nonmedical Nursing Personnel | 1680 Tibbits Ave, Troy, NY 12180 | 2016-06-06 |
| 1518312925 | Matthew Pittelli | Student in an Organized Health Care Education/Training Program | 83 Lockrow Rd, Troy, NY 12180 | 2016-05-04 |
| 1780045765 | Tara Michelle Miller | Hearing Instrument Specialist | 2000 6th Avenue, Troy Towers, Bldg. B, 1st Floor, Troy, NY 12180 | 2016-03-17 |
| 1326410937 | Seton Health System, Inc. | Physician Assistant | 1401 Massachusetts Avenue, Troy Internal Medicine, Troy, NY 12180 | 2015-10-22 |
| Find all providers in zip 12180 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1023560380 | Eating Disorder Treatment of New York, LLC | Clinic/Center | 233 Pine Rd, Briarcliff Manor, NY 10510-2236 | 2016-11-02 |
| 1295188076 | Iv Licensed Clinical Social Work P.C. | Clinic/Center | 4812 Bedford Ave, Apt 1a, Brooklyn, NY 11235-8603 | 2016-07-18 |
| 1548616949 | Lahtze Enterprises LLC | Clinic/Center | 7515 S State St, Lowville, NY 13367-1569 | 2016-05-04 |
| 1306236294 | The Brain Boosters, Inc. | Clinic/Center | 333 Jericho Tpke, Suite 200, Jericho, NY 11753-1100 | 2015-01-29 |
| 1285069641 | Evelyn Torres | Clinic/Center | 4419 Third Avenue, Bronx, NY 10457 | 2013-09-04 |
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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.