Organization
THE HOUSE OF THE GOOD SHEPHERD
Active
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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