Basic Information
| Provider Information | |||||||||
| NPI: | 1083902381 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDINAL MCCLOSKEY SCHOOL AND HOME FOR CHILDREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 E STEVENS AVE STE LL5 | ||||||||
| Address2: | |||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149978000 | ||||||||
| FaxNumber: | 9149972166 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 S 10TH AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105502907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149978000 | ||||||||
| FaxNumber: | 9149972166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2011 | ||||||||
| LastUpdateDate: | 08/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | KAMLESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | COMPLIANCE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9149978000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 315P00000X | NY | Y | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mentally Retarded |
No ID Information.