HUDSON MOHAWK RECOVERY CENTER (NPI# 1851452767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851452767 |
| Entity Type | Organization |
| Organization Name | HUDSON MOHAWK RECOVERY CENTER |
| Practice Address |
1724 5th Ave Troy NY 12180-3320 |
| Practice Telephone | 5182723918 |
| Practice Fax Number | 5182726391 |
| Mailing Telephone | 5182723918 |
| Mailing Fax Number | 5182726391 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-03-16 |
| Authorized Official Name | MR. TOM BENDON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5182723918 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | 090510570 | NY | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00679167 | 05 | |
| NY | MVP INSURANCE | 900267 | 01 |
| Street Address |
1724 5TH AVE |
| City | TROY |
| State | NY |
| Zip Code | 12180-3320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275082562 | Hudson Mohawk Recovery Center Inc | Clinic/Center | 1724 5th Ave, Troy, NY 12180-3541 | 2016-09-27 |
| 1780018200 | Samantha Ste.marie | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-09-03 |
| 1114359007 | Douglas Handy | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-08-02 |
| 1568808087 | Toni M Cochis | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-13 |
| 1174969539 | Lauren Kelly | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-13 |
| 1942645551 | Sarah E Mcclane | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-09 |
| 1457796146 | Roberto C Dimambro | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-08 |
| 1528403102 | Irectorhudson Mohawk Recovery Center | Community/Behavioral Health | 1724 5th Ave, Troy, NY 12180-3320 | 2013-05-08 |
| 1114289972 | Mary Ann Laverty | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2012-06-07 |
| 1184832776 | Craig William Stratton | Counselor | 1724 5th Ave, Troy, NY 12180-3320 | 2007-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1568020857 | Shelby Mara Quintal | Counselor | 7 Collins Ave, Troy, NY 12180 | 2019-05-31 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1104354315 | Karen Lynm Vincent | Licensed Practical Nurse | 830 Hoosick Rd Apt 1, Troy, NY 12180 | 2017-06-01 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1205373263 | Tsu Han Poh | Pharmacist | 204 Washington Street, Apt C1, Troy, NY 12180 | 2017-01-27 |
| 1053760546 | Linda Pierre | Religious Nonmedical Nursing Personnel | 1680 Tibbits Ave, Troy, NY 12180 | 2016-06-06 |
| 1518312925 | Matthew Pittelli | Student in an Organized Health Care Education/Training Program | 83 Lockrow Rd, Troy, NY 12180 | 2016-05-04 |
| 1780045765 | Tara Michelle Miller | Hearing Instrument Specialist | 2000 6th Avenue, Troy Towers, Bldg. B, 1st Floor, Troy, NY 12180 | 2016-03-17 |
| 1326410937 | Seton Health System, Inc. | Physician Assistant | 1401 Massachusetts Avenue, Troy Internal Medicine, Troy, NY 12180 | 2015-10-22 |
| Find all providers in zip 12180 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225654494 | Brooks - Tlc Hospital System, Inc. | Rehabilitation, Substance Use Disorder Unit | 7020 Erie Road, Derby, NY 14047 | 2020-06-23 |
| 1285170514 | Mount Sinai Beth Isreal | Rehabilitation, Substance Use Disorder Unit | 429-35 Second Avenue, Ny, NY 10010-3101 | 2017-01-10 |
| 1760651855 | The Kingston Hospital | Rehabilitation, Substance Use Disorder Unit | 2 Barbarosa Ln, Kingston, NY 12401-1220 | 2008-02-22 |
| 1659443000 | St. Peter's Health Care | Rehabilitation, Substance Use Disorder Unit | 636 New Loudon Rd, Latham, NY 12110-4002 | 2006-11-14 |
| 1740366806 | Kings County Hospital Center | Rehabilitation, Substance Use Disorder Unit | 21-49-46 Street, Astoria, NY 11105 | 2006-10-31 |
| 1417940719 | Delaware Valley Hospital, Inc | Rehabilitation, Substance Use Disorder Unit | 1 Titus Pl, Walton, NY 13856-1457 | 2005-08-23 |
| 1568023687 | Upmc Chautauqua At Wca | Rehabilitation, Substance Use Disorder Unit | 51 Glasgow Ave, Jamestown, NY 14701-6440 | 2019-06-28 |
| 1811368368 | The St. Lukes Roosevelt Hospital Center | Rehabilitation, Substance Use Disorder Unit | 440 W 114th St, New York, NY 10025-1796 | 2015-10-09 |
| 1356754857 | St Lukes Hospital | Rehabilitation, Substance Use Disorder Unit | 1111 Amsterdam Ave, New York, NY 10025-1716 | 2014-06-03 |
| 1992069967 | Brooklyn Hospital Center | Rehabilitation, Substance Use Disorder Unit | 121 Dekalb Ave, Brooklyn, NY 11201-5425 | 2012-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.