Organization · Type 2 NPI
State of New York
Intellectual Disabilities Intermediate Care Facility · Perry, NY
NPI number
1679613145
Active
Practice location
344 Main St S
Perry, NY 14530-9551
Mailing address
44 Holland Ave
Albany, NY 12229-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 00277643 (NY) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1679613145
State of New York's National Provider Identifier is 1679613145, issued on Feb 7, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Perry, NY. The record was last updated on Jun 26, 2008.