Organization Name: | SAMARITAN DAYTOP VILLAGE, INC. |
NPI Number: | 1134240344 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES MADRAY (VP OF HEALTH SERVICES & COMMUNITY B) |
Mailing Address: | 620 Route 303 Blauvelt |
State: | NY US |
Postal Code: | 109131170 |
Phone Number: | 8453532730 |
Fax Number: | 8453532358 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 04/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |