National Provider Identifier Database

STDOMINICS HOMEINC
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

ST.DOMINIC'S HOME,INC
500 WESTERN HWY
BLAUVELT, NY10913-2000
Phone: 845-359-3400
Fax: 845-359-4253
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for ST.DOMINIC'S HOME,INC

NPI Number 1942268818
Legal business name
LBN
ST.DOMINIC'S HOME,INC
Authorized official JUDITH KYDON - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 05/02/2006
Last updated 09/20/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 07159441
  • NY Medicaid: 00475970

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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