Organization
CENTER FOR DISABILITY SERVICES
Active
Other names
West Sand Lake
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA GOULD (SUPERVISOR OF CREDENTIALING)
(518) 437-5717
Entity
Organization
Contact information
Practice address
3995 ROUTE 150, WEST SAND LAKE, NY 12196
(518) 437-5717
Mailing address
314 S MANNING BLVD, ALBANY, NY 12208-1708
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01378234
—
NY
Enumeration date
07/03/2008
Last updated
05/02/2024
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