CATHOLIC CHARITIES DISABILITIES SERVICES
Intermediate Care Facility, Mentally Retarded
Latham, New York
Provider NPI: 1811057383
Organization Information:Organization Name: CATHOLIC CHARITIES DISABILITIES SERVICES
Practice Location:
15 AVIS DR LATHAM, NY 12110 US
Tel: 518-783-1111 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
15 AVIS DR LATHAM, NY 12110 US
Tel: 518-783-1111 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | NY | 7582442 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
01203947 | NY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin