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Organization

GAN KAVOD, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PATRICIA A HAYS ADMINISTRATOR (ADMINISTRATOR OF COMMUNITY SERVICES)
(315) 797-3114
Entity
Organization

Contact information

Practice address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474
Mailing address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01224506
NY
05
01224515
NY
Enumeration date
04/25/2008
Last updated
07/21/2022
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