| Captain Community Human Services, Inc. | |
|
543 Saratoga Rd Glenville NY 12302-5711 | |
| (518) 399-4624 | |
| (518) 399-8663 |
| Full Name | Captain Community Human Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 543 Saratoga Rd, Glenville, New York |
| Authorized Official Name and Position | Andrew John Gilpin (ASSOCIATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5183711185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Captain Community Human Services, Inc. 543 Saratoga Rd Glenville NY 12302-5711 Ph: (518) 399-4624 | Captain Community Human Services, Inc. 543 Saratoga Rd Glenville NY 12302-5711 Ph: (518) 399-4624 |
| NPI Number | 1689039612 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689039612 | NPI | - | NPPES |
| 04724021 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |