Organization
NYS DOCCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY LINDSTRAND (DEPUTY SUPT OF ADMINISTRATION)
(518) 639-5516
Entity
Organization
Contact information
Practice address
11739 STATE ROUTE 22, GREAT MEADOW CORRECTIONAL FACILITY, COMSTOCK, NY 12821-0051
(518) 639-5516
Mailing address
PO BOX 51, 11739 STATE ROUTE 22, COMSTOCK, NY 12821-0051
(518) 639-5516
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
000650-1
NY
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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