Organization · Type 2 NPI

St. Peter's Hospital of the City of Albany

Substance Use Disorder Rehabilitation Clinic/Center · Latham, NY

NPI number 1194943670 Active

Practice location

636 New Loudon Road
Latham, NY 12110-4002

Call (518) 783-5381 Map

Mailing address

PO Box 14890
Albany, NY 12212-4890

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Psychiatry Physician	2084P0800X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None listed
Substance Use Disorder Rehabilitation Clinic/Center Primary	261QR0405X	0101004H (NY)
General Acute Care Hospital	282N00000X	0101004H (NY)
Physician Assistant	363A00000X	None listed
Nurse Practitioner	363L00000X	None listed
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	None listed

Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...

NPI record

NPI: 1194943670
Entity type: Organization (Type 2)
Issued: Apr 23, 2007
Last updated: May 24, 2023
Status: Active
Subpart: Yes of St. Peter's Hospital of the City of Albany

Other names

<unavail>
St. Peter's Addiction Recovery Center · other name

Authorized official

Courtney Knowles
Credentialing & Enrollment Manager
(518) 525-5634

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1194943670

St. Peter's Hospital of the City of Albany's National Provider Identifier is 1194943670, issued on Apr 23, 2007. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Latham, NY. The record was last updated on May 24, 2023.