Organization
PARK HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG W MEYER (ASSISTANT CONTROLLER)
(516) 870-1643
Entity
Organization
Contact information
Practice address
191 SWEET HOLLOW RD, OLD BETHPAGE, NY 11804-1342
(516) 870-1643
(516) 870-1671
Mailing address
191 SWEET HOLLOW RD, OLD BETHPAGE, NY 11804-1342
(516) 870-1643
(516) 870-1671
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01304136
—
NY
Enumeration date
10/24/2008
Last updated
10/24/2008
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