THE WILLIAM GEORGE AGENCY
NPI 1588714265
Residential Treatment Facility, Emotionally Disturbed Children in Freeville, NY

Q: What is the provider's specialty?

The provider's specialty is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since January 12, 2007CLIA 33D2158000 · Waiver

380 FREEVILLE RD, FREEVILLE, NY 13068(607) 844-6210(607) 844-4991 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

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About The William George Agency NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE WILLIAM GEORGE AGENCY (NPI 1588714265), doing business as The George Junior Republic, is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Freeville, New York and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Scott Adams, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1588714265

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameTHE WILLIAM GEORGE AGENCY

Location Address380 FREEVILLE RDFreeville, NY 13068-9684

Mailing Address380 Freeville RdFreeville, NY 13068-9684 · (607) 844-6210 · Fax (607) 844-4991

Phone(607) 844-6210

Fax(607) 844-4991

Organization SubpartNo

Authorized OfficialScott AdamsBusiness Manager · (607) 844-6210

Enumeration DateJanuary 12, 2007

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1588714265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

380 FREEVILLE RD, Freeville, NY 13068

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Other Names 1

Former Legal Business NameThe George Junior Republic

Other Identifiers 2

Medicaid00353562NY

Medicaid02077741NY

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 33D2158000
Facility Type: Comp. Outpatient Rehab Facility
Certificate Effective Date: November 19, 2018
Certificate Expiration Date: March 26, 2027
Laboratory Director: DR. WILLIAM C. SHEPARD
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to The William George Agency to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.