National Provider Identifier Database

NEW YORK STATE
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

NEW YORK STATE
51 SINPATCH RD
WASSAIC, NY12592-2410
Phone: 845-877-3109
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for NEW YORK STATE

NPI Number 1871871020
Legal business name
LBN
NEW YORK STATE
Authorized official KARLA SMITH - (DIRECTOR OF CENTRAL OPERATIONS)
Entity Organization
Organization subpart Yes
Enumeration date 07/21/2011
Last updated 07/21/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 00275789

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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