Healthcare Provider Details

I. General information

NPI: 1629580857
Provider Name (Legal Business Name): SADIE'S PLACE NY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 10/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 BOARDMAN RD STE 3
POUGHKEEPSIE NY
12603-4871
US

IV. Provider business mailing address

19 SLATE HILL DR
POUGHKEEPSIE NY
12603-5509
US

V. Phone/Fax

Practice location:
  • Phone: 845-849-1007
  • Fax:
Mailing address:
  • Phone: 845-849-1007
  • Fax: 845-849-3554

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: DR. STACEY LAMAR
Title or Position: OWNER
Credential:
Phone: 845-849-1007