Organization
WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Active
Parent organization
WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Other names
Mobile Van Unit
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Authorized official
DAVID H SHIPPEE (CEO/PRESIDENT)
(518) 465-4771
Entity
Organization
Contact information
Practice address
920 LARK DR, WHITNEY M. YOUNG JR. HEALTH CENTER - MOBILE VAN, ALBANY, NY 12207-1300
(518) 465-4771
(518) 320-3022
Mailing address
320 SEVENTH AVENUE, TROY, NY 12182
(518) 465-4771
(518) 320-3022
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
0101205R
NY
261QF0400X
Federally Qualified Health Center (FQHC)
0101205R
NY
261QP2300X
Primary Care Clinic/Center
010120R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473565
—
NY
Enumeration date
12/17/2014
Last updated
12/17/2014
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