Provider Demographics
NPI:1891840146
Name:COLUMBIA COUNTY DEPARTMENT OF HEALTH
Entity type:Organization
Organization Name:COLUMBIA COUNTY DEPARTMENT OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PRESCHOOL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:518-828-4278
Mailing Address - Street 1:325 COLUMBIA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1905
Mailing Address - Country:US
Mailing Address - Phone:518-828-4278
Mailing Address - Fax:518-671-6738
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1905
Practice Address - Country:US
Practice Address - Phone:518-828-4278
Practice Address - Fax:518-671-6738
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBIA COUNTY DEPARTMENT OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-25
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01430491Medicaid