Provider Demographics
NPI:1740401041
Name:ORANGE COUNTY DEPT. OF HEALTH
Entity Type:Organization
Organization Name:ORANGE COUNTY DEPT. OF HEALTH
Other - Org Name:ORANGE COUNTY DOH LONG TERM HOME HEALTH CARE PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:845-291-2332
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:845-291-2332
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:845-291-2332
Practice Address - Fax:845-291-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3523901L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00901437Medicaid
NY00901437Medicaid