Organization
VILLA MARY IMMACULATE
Active
Other names
St. Peter's Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN COOPER (EXECUTIVE DIRECTOR)
(518) 525-7670
Entity
Organization
Contact information
Practice address
301 HACKETT BLVD, ALBANY, NY 12208-1963
(518) 525-7600
(518) 525-7673
Mailing address
301 HACKETT BLVD, ALBANY, NY 12208-1963
(518) 525-7600
(518) 525-7673
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0101305N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00310081
—
NY
Enumeration date
09/12/2005
Last updated
08/22/2020
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