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Organization
ESSEX COUNTY CHAPTER NYSARC, INC
Active
Organization
ESSEX COUNTY CHAPTER NYSARC, INC
Active
Other names
Mountain Lake Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J NEPHEW EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(518) 546-3381
Entity
Organization
Contact information
Practice address
10 ST PATRICK PL, PORT HENRY, NY 12974-1200
(518) 546-3381
(518) 546-7138
Mailing address
10 ST PATRICK PL, PORT HENRY, NY 12974-1200
(518) 546-3381
(518) 546-7138
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
15090188021
NY
Other
Enumeration date
06/21/2017
Last updated
07/21/2022
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