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Contact Information

MENORAH PARK GROUP RESIDENTS
12 JAMAR DRIVE
DEWITT, NY13066
 Phone: 315-446-9111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

261QD1600X
Indicates primary specialty

NPI Profile & details for MENORAH PARK GROUP RESIDENTS

NPI Number 1689815805
LBN Legal business name MENORAH PARK GROUP RESIDENTS
Authorized official TONI COLE - (OFFICE)
Entity Organization
Organization subpart 1 No
Enumeration date 03/18/2009
Last updated 03/18/2009 - About 17 years ago
Identifiers
NY License # SPV46480
NY Medicaid 03035921
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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