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State Of New York
Intellectual Disabilities Intermediate Care Facility in Coram, New York
NPI 1134269525

State Of New York is a Intellectual Disabilities Intermediate Care Facility based in Albany, NY. State Of New York practices in Coram, NY. The NPI Number for State Of New York is 1134269525 and holds a License No. 00227844 (New York).

The current practice location address for State Of New York is 85 W Yaphank Rd, Coram, NY and can be reached out via phone at 518-402-4333.

Location: 85 W Yaphank Rd, Coram, NY, 12229-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134269525
Provider Name
State Of New York
Credential
Provider Entity Type
Organization
Address
85 W Yaphank Rd, Coram, NY, 12229-0001
Phone Number
518-402-4333
Fax Number
Provider Enumeration Date
02/07/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00999913 05 NY
institution
Provider Business Practice Location Address Details
Address
85 W Yaphank Rd
City
Coram
State
New York
Zip
11727-4025
Phone Number
518-402-4333
Fax Number
person
Provider Business Mailing Address Details
Address
85 W Yaphank Rd
City
Coram
State
New York
Zip
11727-4025
Phone Number
518-402-4333
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
00227844 (New York)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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