Organization Name: | ST.DOMINIC'S HOME,INC |
NPI Number: | 1922066737 |
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: | 05/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | 22280 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |