Organization
EDEN PARK HEALTH SERVICES, INC
Active
Other names
Eden Park Health Services, Inc. ALP
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GLOCK (PRESIDENT)
(518) 436-4731
Entity
Organization
Contact information
Practice address
2405 15TH ST, TROY, NY 12180-1702
(518) 266-9654
Mailing address
22 HOLLAND AVE, ALBANY, NY 12209-1713
(518) 436-4731
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
600-F-246
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06066571
—
NY
Enumeration date
11/09/2006
Last updated
08/22/2020
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