State of New York

NPI #1679613145 in Perry, New York

Provider Information

NPI Number
1679613145
Entity Type
Organization
Organization Name
State of New York
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF NEW YORK
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Feb 7, 2007
Last Updated
Jun 26, 2008

Practice Location

Address
344 MAIN ST S
City
Perry
ZIP Code
14530-9551
Phone
(518) 402-4333

Authorized Official

Name
KARLA SMITH
Title
DIRECTOR OF CENTRAL OPERATIONS
Phone
(518) 402-4333

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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