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General NPI Number Information
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NPI Number | 1023174760
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Entity Type | Organization
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Legal Business Name | CAMP VENTURE, INC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 MARYCREST RD
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City | WEST NYACK
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State | NY
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Zip | 10994-2404
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Country | US
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Telephone | 845-624-5324
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Fax |
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Provider Business Mailing Address
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Address Line | 25 SMITH ST SUITE 512
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City | NANUET
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State | NY
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Zip | 10954-2912
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Country | US
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Telephone | 845-624-5324
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DANIEL LUKENS
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Credential |
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Telephone | 845-624-5324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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