NPI 1013056712

State of New York

Organisation Intellectual Disabilities Intermediate Care Facility Staten Island, NY

Practice location

Address: 777 Seaview Ave, Staten Island, NY 10314
Phone: (518) 402-4333
Mailing address: 44 Holland Ave, Albany, NY 12229-0001

Authorised official

Name: Karla Smith
Title: Director of Central Operations
Phone: (518) 402-4333

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence OMRDD276 (NY)

Other Intermediate Care Facility, Intellectual Disabilities providers in New York →

Registry record

NPI: 1013056712
Entity type: Organization
NPI issued: 6 Feb 2007
Record last updated: 25 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.