Provider Demographics
NPI:1831147347
Name:COUNTY OF ORANGE
Entity Type:Organization
Organization Name:COUNTY OF ORANGE
Other - Org Name:RESIDENTIAL HEALTH CARE FACILITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LADUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-291-4700
Mailing Address - Street 1:2 GLENMERE COVE ROAD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924
Mailing Address - Country:US
Mailing Address - Phone:845-291-4700
Mailing Address - Fax:845-291-4715
Practice Address - Street 1:2 GLENMERE COVE ROAD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-291-4747
Practice Address - Fax:845-291-4715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3523301N320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0702OtherPFI#
NY3523301NOtherOPCERT#
NY00473267Medicaid
NY00473267Medicaid