Organization
ACHIEVEMENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI CALLISTER (EXECUTIVE DIRECTOR)
(518) 782-1178
Entity
Organization
Contact information
Practice address
623 NEW LOUDON RD, LATHAM, NY 12110-4031
(518) 782-1178
Mailing address
623 NEW LOUDON RD, LATHAM, NY 12110-4031
(518) 782-1178
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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