State Of New York
Intermediate Care Facility, Intellectual Disabilities in Wassaic, NY. Organization (NPI-2).
Details
- NPI
- 1487906368
- Entity type
- Organization (NPI-2)
- Legal business name
- State Of New York
- Organization subpart
- Yes
- Enumeration date
- Oct 3, 2012
- Last updated
- Oct 3, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | 0275791 | NY | Yes |
Other names
- Taconic Ddso (Other Name)
Practice location
22 Sinpatch RdWassaic, NY 12592-2432
Phone 518-402-4333 · Fax 518-408-2465
Mailing address
44 Holland AveAlbany, NY 12208-3411
Phone 518-402-4333
Authorized official
Karla Smith
Director Of Central Operations
5184024333
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Intellectual Disabilities Intermediate Care Facility providers in Wassaic · All 22 providers in Wassaic
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