Organization
CAMP VENTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LUKENS (EXECUTIVE DIRECTOR)
(845) 624-5324
Entity
Organization
Contact information
Practice address
100 CONVENT RD, NANUET, NY 10954-3106
(845) 624-5322
Mailing address
25 SMITH ST, SUITE 512, NANUET, NY 10954-2912
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00546034
—
NY
Enumeration date
11/30/2006
Last updated
08/22/2020
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