Healthcare Provider Details

I. General information

NPI: 1194754366
Provider Name (Legal Business Name): DAUGHTERS OF SARAH NURSING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 WASHINGTON AVENUE EXT
ALBANY NY
12203-5347
US

IV. Provider business mailing address

180 WASHINGTON AVENUE EXT
ALBANY NY
12203-5347
US

V. Phone/Fax

Practice location:
  • Phone: 518-456-7831
  • Fax: 518-456-1563
Mailing address:
  • Phone: 518-456-7831
  • Fax: 518-456-1563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0101312N
License Number StateNY

VIII. Authorized Official

Name: COURTNEY MULSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 518-456-7831