Provider Demographics
NPI:1609985571
Name:NYSARC, INC., SULLIVAN-ORANGE-DUTCHESS COUNTIES CHAPTER
Entity Type:Organization
Organization Name:NYSARC, INC., SULLIVAN-ORANGE-DUTCHESS COUNTIES CHAPTER
Other - Org Name:THE ARC GREATER HUDSON VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNY-SNEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-796-1350
Mailing Address - Street 1:162 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-8815
Mailing Address - Country:US
Mailing Address - Phone:845-796-1350
Mailing Address - Fax:845-796-3213
Practice Address - Street 1:162 E BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-8815
Practice Address - Country:US
Practice Address - Phone:845-796-1350
Practice Address - Fax:845-796-3213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6206471261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02782016Medicaid
NY005365Medicaid