Organization
SAMARITAN DAYTOP VILLAGE, INC.
Active
Other names
Daytop Village, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MADRAY MBA (VP OF HEALTH SERVICES & COMMUNITY B)
(718) 206-2000
Entity
Organization
Contact information
Practice address
620 ROUTE 303, BLAUVELT, NY 10913-1170
(845) 353-2730
(845) 353-2358
Mailing address
54 W 40TH ST, NEW YORK, NY 10018-2602
(212) 354-6000
(211) 238-2389
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00659687
—
NY
01
—
7002121R
DEPT OF HEALTH ART 28 CER
NY
Enumeration date
04/03/2007
Last updated
04/29/2016
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