NPIMap

Organization Active NPI

County of Orange

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Jervis, NY
National Provider Identifier
1740227214
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
7201109A Issued in NY
Legal business name
COUNTY OF ORANGE
Practice address
146 Pike Street
Port Jervis, NY 12771
Phone
(845) 858-1456
Fax
(845) 858-1459
NPI assigned
Jun 1, 2006
Last updated
Jul 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Indira Smith
Title
Program Evaluation Assistant
Phone
(845) 291-2902

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7201109A NY Primary
Adult Mental Health Clinic/Center 261QM0850X 7201109A NY
Adolescent and Children Mental Health Clinic/Center 261QM0855X 7201109A NY

Addresses

Primary practice location

146 Pike Street
Port Jervis, NY 12771

Mailing address

30 Harrman Drive
Goshen, NY 10924
Phone (845) 291-2600

Other identifiers 2

IdentifierTypeStateIssuer
03004253MedicaidNY
00542503MedicaidNY

Other names 2

  • County of Orange, Department of Mental Health Other name
  • Port Jervis Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000995 NY Part B Supplier - Clinic/Group Practice 0648169185 Receives reassigned benefits from 40 practitioners
1 other NPI on this enrollment
Practice locations: Newburgh, NY; Port Jervis, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Orange

    dba The Valley View Certified Home Health Agency

    • Home Health Agency
    • Goshen, NY
    • NPI 1073016952

    0648169185

    Same PAC ID
  • County of Orange

    dba The Valley View Center for Nursing Care and Rehabilitation

    • Physical Disabilities Residential Treatment Facility
    • Goshen, NY
    • NPI 1831147347

    0648169185

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • County of Orange

    dba Orange County Dept. of Mental Health

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Newburgh, NY
    • NPI 1295889806

    O20040312000995

    Same enrollment

National Provider Directory

National Provider Directory
Tax ID family
Orange County Dept of Health17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Valley View Center for Nursing Care and RehabilitationGoshen, NY, CCN 335238 Skilled nursing facility Other (100%) Jan 1, 1966
The Valley View Certified Home Health AgencyGoshen, NY, CCN 337150 Home health agency Operational/Managerial Control (100%) Nov 1, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Orange

    dba The Valley View Certified Home Health Agency

    • Home Health Agency
    • Goshen, NY
    • NPI 1073016952

    Operational/Managerial Control

    CMS ownership
  • County of Orange
    • Home Health Agency
    • Goshen, NY
    • NPI 1598973596

    Operational/Managerial Control

    CMS ownership
  • County of Orange

    dba The Valley View Center for Nursing Care and Rehabilitation

    • Physical Disabilities Residential Treatment Facility
    • Goshen, NY
    • NPI 1831147347

    Other

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1740227214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HARRMAN DRIVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-2600",
            "fax_number": "845-291-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 PIKE STREET",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "12771",
            "telephone_number": "845-858-1456",
            "fax_number": "845-858-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ORANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "INDIRA",
        "authorized_official_title_or_position": "PROGRAM EVALUATION ASSISTANT",
        "authorized_official_telephone_number": "845-291-2902"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7201109A",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "7201109A",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NY",
            "license": "7201109A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03004253",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00542503",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County of Orange, Department of Mental Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Port Jervis Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.