Organization
SPECIAL NEEDS PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY MEROL HIME (CEO)
(518) 822-1054
Entity
Organization
Contact information
Practice address
1351 ROUTE 66, GHENT, NY 12075
(518) 822-1054
(518) 822-0739
Mailing address
1351 ROUTE 66, P.O. BOX 349, GHENT, NY 12075
(518) 822-1054
(518) 822-0739
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00979800
—
NY
05
—
01825992
—
NY
05
—
02003249
—
NY
05
—
02111080
—
NY
05
—
02250008
—
NY
05
—
02363495
—
NY
05
—
02587364
—
NY
05
—
02587373
—
NY
05
—
02597597
—
NY
05
—
02648286
—
NY
05
—
02701320
—
NY
Enumeration date
06/28/2007
Last updated
08/09/2007
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