Healthcare Provider Details

I. General information

NPI: 1689866824
Provider Name (Legal Business Name): OPPORTUNITIES NORTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2007
Last Update Date: 08/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 STATE ROUTE 9
LAKE GEORGE NY
12845-6304
US

IV. Provider business mailing address

444 DIXON RD
QUEENSBURY NY
12804-1959
US

V. Phone/Fax

Practice location:
  • Phone: 518-668-4353
  • Fax: 518-668-2241
Mailing address:
  • Phone: 518-668-4353
  • Fax: 518-668-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. JESSYCA A TOKOS-DARRAH
Title or Position: PRESIDENT
Credential:
Phone: 518-668-4353