Provider Demographics
NPI:1033360003
Name:JILLYS PLACE INC
Entity Type:Organization
Organization Name:JILLYS PLACE INC
Other - Org Name:CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LMSW
Authorized Official - Phone:845-496-1966
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:WESTTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10998-0241
Mailing Address - Country:US
Mailing Address - Phone:845-496-1966
Mailing Address - Fax:845-496-1976
Practice Address - Street 1:10 WEATHERVANE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-2242
Practice Address - Country:US
Practice Address - Phone:845-496-1966
Practice Address - Fax:845-496-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0512981251300000X, 251B00000X, 252Y00000X
3464851251300000X
NY3464851251S00000X
NY4364851252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health