| Organization Name: | ST.DOMINIC'S HOME,INC |
| NPI Number: | 1417905548 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH D KYDON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 500 Western Hwy Blauvelt |
| State: | NY US |
| Postal Code: | 109132000 |
| Phone Number: | 8453593400 |
| Fax Number: | 8453594253 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385HR2060X |
| License Number: | RSP22280 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |