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State Of New York
Intellectual Disabilities Intermediate Care Facility in Tupper Lake, New York
NPI 1720127418

State Of New York is a Intellectual Disabilities Intermediate Care Facility based in Albany, NY. State Of New York practices in Tupper Lake, NY. The NPI Number for State Of New York is 1720127418 and holds a License No. 00225049 (New York).

The current practice location address for State Of New York is 19 Hosley Ave, Tupper Lake, NY and can be reached out via phone at 518-402-4333.

Location: 19 Hosley Ave, Tupper Lake, NY, 12229-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720127418
Provider Name
State Of New York
Credential
Provider Entity Type
Organization
Address
19 Hosley Ave, Tupper Lake, NY, 12229-0001
Phone Number
518-402-4333
Fax Number
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01329157 05 NY
institution
Provider Business Practice Location Address Details
Address
19 Hosley Ave
City
Tupper Lake
State
New York
Zip
12986
Phone Number
518-402-4333
Fax Number
person
Provider Business Mailing Address Details
Address
19 Hosley Ave
City
Tupper Lake
State
New York
Zip
12986
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.
00225049 (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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