Organization · Type 2 NPI

State of New York

Intellectual Disabilities Intermediate Care Facility · Staten Island, NY

NPI number 1013056712 Active

Practice location

777 Seaview Ave
Staten Island, NY 10314

Call (518) 402-4333 Map

Mailing address

44 Holland Ave
Albany, NY 12229-0001

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XOMRDD276 (NY)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1013056712

State of New York's National Provider Identifier is 1013056712, issued on Feb 6, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Staten Island, NY. The record was last updated on Jun 25, 2008.