NPIMap

Organization Active NPI

State of New York

  • Intellectual Disabilities Intermediate Care Facility
  • Wassaic, NY
National Provider Identifier
1871890590
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
00275788 Issued in NY
Legal business name
STATE OF NEW YORK
Practice address
18 Sinpatch Rd
Wassaic, NY 12592-2432
Phone
(518) 402-4333
NPI assigned
Feb 15, 2011
Last updated
Feb 15, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Karla J Smith
Title
Director of Central Operations
Phone
(518) 402-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 00275788 NY Primary

Addresses

Primary practice location

18 Sinpatch Rd
Wassaic, NY 12592-2432

Mailing address

44 Holland Avenue
Albany, NY 12229-0001
Phone (518) 402-4333

Other names 1

  • Taconic DDSO Other name

National Provider Directory

National Provider Directory
Tax ID family
Ibr Consolidated Lab Rev269 organizations share this tax ID, including this one
Part of
Ibr Consolidated Lab Rev

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1871890590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVENUE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001",
            "telephone_number": "518-402-4333",
            "fax_number": "518-473-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SINPATCH RD",
            "city": "WASSAIC",
            "state": "NY",
            "postal_code": "125922432",
            "telephone_number": "518-402-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEW YORK",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF CENTRAL OPERATIONS",
        "authorized_official_telephone_number": "518-402-4333"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "00275788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taconic DDSO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wassaic, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.