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Organization

SPARC LATHAM

Active
Parent organization
ST. PETER'S HOSPITAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST. PETER'S HOSPITAL
Authorized official
MR. TOM BENDON (PROGRAM MANAGER)
(518) 783-5381
Entity
Organization

Contact information

Practice address
636 NEW LOUDON RD, LATHAM, NY 12110-4002
(518) 783-5381
(518) 783-0125
Mailing address
636 NEW LOUDON RD, LATHAM, NY 12110-4002
(518) 783-5381
(518) 783-0125

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
03/24/2009
Last updated
03/24/2009
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