Organization
THE HOUSE OF THE GOOD SHEPHERD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN MCKEE (CEO)
(315) 235-7799
Entity
Organization
Contact information
Practice address
1550 CHAMPLIN AVE, UTICA, NY 13502-4828
(315) 235-7780
(315) 235-7789
Mailing address
1550 CHAMPLIN AVE, UTICA, NY 13502-4828
(315) 235-7780
(315) 235-7789
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
RID1658/VID00A01020
NY
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
8927040
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00356565
—
NY
05
—
01552327
—
NY
Enumeration date
09/04/2007
Last updated
09/24/2021
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