Organization
STATE OF NEW YORK
Active
Parent organization
STATE OF NEW YORK
Other names
WESTERN NY DDSO
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW YORK
Authorized official
KARLA J SMITH (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
526 LEYDECKER RD, WEST SENECA, NY 14224-3731
(716) 675-0367
Mailing address
44 HOLLAND AVENUE, ALBANY, NY 12229-0001
(518) 402-4333
(518) 408-2465
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0026486
NY
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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