THE WILLIAM GEORGE AGENCY (NPI# 1588714265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588714265 |
| Entity Type | Organization |
| Organization Name | THE WILLIAM GEORGE AGENCY |
| Other Organization Name | THE GEORGE JUNIOR REPUBLIC |
| Practice Address |
380 Freeville Rd Freeville NY 13068-9684 |
| Practice Telephone | 6078446210 |
| Practice Fax Number | 6078444991 |
| Mailing Telephone | 6078446210 |
| Mailing Fax Number | 6078444991 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. SCOTT ADAMS (BUSINESS MANAGER) |
| Authorized Official Telephone | 6078446210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | ========= | NY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00353562 | 05 | |
| NY | 02077741 | 05 |
| Other Name | Type Code |
|---|---|
| The George Junior Republic | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | THE WILLIAM GEORGE AGENCY FOR CHILDREN'S SERVICES, INC. | 380 Freeville Road, Freeville, Ny 13068 |
| Street Address |
380 FREEVILLE RD |
| City | FREEVILLE |
| State | NY |
| Zip Code | 13068-9684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366965 | Amanda Comfort | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-11-03 |
| 1831799642 | Kody Mcgraw | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-10-30 |
| 1760081012 | Heather Arnold | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-10-19 |
| 1801404959 | Cheyenne L Jackson I | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-07-15 |
| 1336763820 | Jesselea Spears | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-06-01 |
| 1972134351 | Hilary Reilly | Social Worker | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-02-04 |
| 1447882824 | Renee J Damon | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-02-04 |
| 1841820362 | Katilyn Butler | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-01-23 |
| 1831729359 | Nicole Williams | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-01-23 |
| 1013557859 | Jennifer Dupay | Counselor | 380 Freeville Rd, Freeville, NY 13068-9684 | 2020-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699092643 | Joanne Marie Lorenc | Social Worker | 380 Freeville Rd., Freeville, NY 13068 | 2010-04-30 |
| 1235285396 | Cynthia Marie Palmer-elberty | Dentist | 1 Brooklyn Road, Freeville, NY 13068 | 2007-01-25 |
| 1508402710 | Finger Lakes Dermatology Pllc | Dermatology | 2141 Dryden Rd, Freeville, NY 13068 | 2019-11-22 |
| 1205942752 | Colin Kenneth Dauria | Psychiatry & Neurology | 1451 Dryden Rd, Tompkins/cortland Va Cboc, Freeville, NY 13068 | 2006-08-21 |
| 1629049267 | Richard Weiner | Specialist | 24 Main Street, Freeville, NY 13068 | 2006-01-31 |
| 1861611808 | Wayne H Seeley Dmd PC | Dentist | 2028 Dryden Road, Freeville, NY 13068-0317 | 2007-04-25 |
| 1740305770 | Wayne H Seeley | Dentist | 2028 Dryden Rd, Freeville, NY 13068-0317 | 2007-03-20 |
| 1841436953 | Jens L. Wennberg | Physician Assistant | 501 Midline Rd, Freeville, NY 13068-5625 | 2008-12-18 |
| 1689018038 | Susan R Yanoff | Veterinarian | 295 Irish Settlement Rd, Freeville, NY 13068-5633 | 2013-04-28 |
| 1033448485 | Penny H Baron | Specialist | 445 Ferguson Rd, Freeville, NY 13068-5637 | 2009-12-14 |
| Find all providers in zip 13068 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
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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.