Organization
BAKER HALL
Active
Other names
OLV Human Services, Baker Victory Services
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL PARZYCH (CFO/COO)
(716) 828-9751
Entity
Organization
Contact information
Practice address
170 MARTIN ROAD, LACKAWANNA, NY 14218-2708
(716) 828-7470
(716) 827-8581
Mailing address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
NY
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7600442
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01129955
—
NY
Enumeration date
05/24/2007
Last updated
04/15/2024
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