Organization
STATE OF NEW YORK
Active
Parent organization
STATE OF NEW YORK
Other names
Cedar Lane ICF
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
50 CEDAR LANE, WASSAIC, NY 12592
(518) 402-4333
Mailing address
44 HOLLAND AVENUE, ALBANY, NY 12229-0001
(518) 402-4333
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0275787
NY
Other
Enumeration date
12/07/2009
Last updated
12/07/2009
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