Provider Demographics
NPI:1598977308
Name:COUNTY OF ORANGE
Entity Type:Organization
Organization Name:COUNTY OF ORANGE
Other - Org Name:ORANGE CO. DEPT. OF HEALTH EARLY INTERVENTION PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:N
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD, MPH, FCLM
Authorized Official - Phone:845-360-6600
Mailing Address - Street 1:124 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2124
Mailing Address - Country:US
Mailing Address - Phone:845-360-6600
Mailing Address - Fax:845-291-2341
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2124
Practice Address - Country:US
Practice Address - Phone:845-360-6600
Practice Address - Fax:845-291-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00472913Medicaid