St. Luke Residential Health Care Facility, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ST. LUKE RESIDENTIAL HEALTH CARE FACILITY, INC.

Practice address

299 E River Rd
Oswego, NY 13126-6400

Phone

(315) 342-3166

Fax

(315) 343-6531

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Shelly Youngs

Title

Controller

Phone

(315) 342-3166

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Luke ADHC Other name

Tax ID family

St Luke Adhc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St Luke Home Health Services

  • Home Health Agency
  • Oswego, NY
  • NPI 1487731592
  NPD tax ID

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1467534974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 E RIVER RD",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266400",
            "telephone_number": "315-342-3166",
            "fax_number": "315-343-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 E RIVER RD",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266400",
            "telephone_number": "315-342-3166",
            "fax_number": "315-343-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE RESIDENTIAL HEALTH CARE FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "YOUNGS",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "315-342-3166"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01407538",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke ADHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie Leah Spicer, LPN
• Shannon Spink, DPT
• Jill St John, RN LMT
• St Luke Home Health Services
• Jean Patrick St. Croix
• St. Luke Residential Health Care Facility, Inc.
• Christeen Amber Staats
• Mary Virginia Stamm, LPN
• Emily Susan Steele, MS
• Shelley M Steele, LPN

• Adult Day Care Clinic/Center in Oswego, NY
• Providers in Oswego, NY by specialty
• Adult Day Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.