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Medicaid
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Valley Stream, New York
NPI 1609990712

Medicaid is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Valley Stream, NY. Medicaid practices in Valley Stream, NY. The NPI Number for Medicaid is 1609990712 and holds a License No. 265009 (New York).

The current practice location address for Medicaid is 329 W Jamaica Ave, Valley Stream, NY and can be reached out via phone at 516-812-7614.

Location: 329 W Jamaica Ave, Valley Stream, NY, 11580-5322
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1609990712
Provider Name
Medicaid
Credential
Provider Entity Type
Organization
Address
329 W Jamaica Ave, Valley Stream, NY, 11580-5322
Phone Number
516-812-7614
Fax Number
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
329 W Jamaica Ave
City
Valley Stream
State
New York
Zip
11580-5322
Phone Number
516-812-7614
Fax Number
person
Provider Business Mailing Address Details
Address
329 W Jamaica Ave
City
Valley Stream
State
New York
Zip
11580-5322
Phone Number
516-812-7614
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
265009 (New York)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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