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General NPI Number Information
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NPI Number | 1326114695
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Entity Type | Organization
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Legal Business Name | LIVING RESOURCES CORPORATION
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 149 CARDINAL AVE
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City | ALBANY
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State | NY
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Zip | 12209-1105
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Country | US
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Telephone | 518-489-7665
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Fax | 518-435-9519
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Provider Business Mailing Address
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Address Line | 149 CARDINAL AVE
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City | ALBANY
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State | NY
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Zip | 12209-1105
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Country | US
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Telephone | 518-489-7665
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Fax | 518-435-9519
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | FREDRICK WILLIAM ERLICH
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Credential |
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Telephone | 518-346-8888
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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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