Healthcare Provider Details

I. General information

NPI: 1750453148
Provider Name (Legal Business Name): THE DANFORTH ADULT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DANFORTH ST
HOOSICK FALLS NY
12090-1223
US

IV. Provider business mailing address

19 DANFORTH ST
HOOSICK FALLS NY
12090-1223
US

V. Phone/Fax

Practice location:
  • Phone: 518-686-5167
  • Fax: 518-686-4428
Mailing address:
  • Phone: 518-686-5167
  • Fax: 518-686-4428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License NumberCJD8027
License Number StateNY

VIII. Authorized Official

Name: MRS. DONNA J. HOPKINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 518-686-5167