NPIMap

Organization Active NPI

St. Colman's Home Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Watervliet, NY
National Provider Identifier
1144351339
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
VID 00A02095 Issued in NY
Legal business name
ST. COLMAN'S HOME INC.
Practice address
11 Haswell Rd
Watervliet, NY 12189-1302
Phone
(518) 273-4911
Fax
(518) 273-3312
NPI assigned
Mar 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mother Mary Carmel
Title
Executive Director
Phone
(518) 273-4911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X VID 00A02095 NY Primary

Addresses

Primary practice location

11 Haswell Rd
Watervliet, NY 12189-1302

Mailing address

11 Haswell Rd
Watervliet, NY 12189-1302
Phone (518) 273-4911

Other identifiers 1

IdentifierTypeStateIssuer
00353622MedicaidNY

National Provider Directory

National Provider Directory

Locations

11 Haswell Rd
Watervliet, NY 12189
Phone (518) 273-4911

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144351339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HASWELL RD",
            "city": "WATERVLIET",
            "state": "NY",
            "postal_code": "121891302",
            "telephone_number": "518-273-4911",
            "fax_number": "518-273-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HASWELL RD",
            "city": "WATERVLIET",
            "state": "NY",
            "postal_code": "121891302",
            "telephone_number": "518-273-4911",
            "fax_number": "518-273-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. COLMAN'S HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARMEL",
        "authorized_official_first_name": "MOTHER",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "518-273-4911"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": "VID 00A02095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00353622",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watervliet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.