Healthcare Provider Details

I. General information

NPI: 1649333485
Provider Name (Legal Business Name): UNITY HOUSE OF TROY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 2ND ST
TROY NY
12180-3904
US

IV. Provider business mailing address

2431 6TH AVE
TROY NY
12180-2227
US

V. Phone/Fax

Practice location:
  • Phone: 518-274-2607
  • Fax:
Mailing address:
  • Phone: 518-274-2607
  • Fax: 518-274-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. STACEY FAULISI
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 518-274-2607