Organization · Type 2 NPI
State of New York
Intellectual Disabilities Intermediate Care Facility · Tupper Lake, NY
NPI number
1689713372
Active
Practice location
21 Hosley Ave
Tupper Lake, NY 12986
Mailing address
44 Holland Ave
Albany, NY 12229-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 00225050 (NY) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
Other intellectual disabilities intermediate care facility providers in Tupper Lake
About NPI 1689713372
State of New York's National Provider Identifier is 1689713372, issued on Feb 6, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Tupper Lake, NY. The record was last updated on Jun 25, 2008.