Organization
ADIRONDACK MANOR HOME FOR ADULTS
Active
Other names
Montcalm Manor Home for Adults, Scoita Masion, Willow Park Home for Adults, Adirondack Manor Home for Adults ALP, Adirondack Manor Home Care Agency, Valehaven Home for Adults
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER GRAJALES (PROJECT MANAGER/EXECUTIVE ASSISTANT)
(347) 988-4535
Entity
Organization
Contact information
Practice address
653 BAY RD, QUEENSBURY, NY 12804-1446
(718) 840-3355
(518) 244-9105
Mailing address
2357 60TH ST, BROOKLYN, NY 11204-2689
(718) 840-3355
(516) 244-9105
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0623L001
LHCSA LICENSE NO.
NY
Enumeration date
08/20/2020
Last updated
11/12/2020
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