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General NPI Number Information
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NPI Number | 1447504550
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Entity Type | Organization
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Legal Business Name | INDEPENDENT LIVING CENTER OF THE HUDSON VALLEY, INC.
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 15 3RD ST
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City | TROY
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State | NY
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Zip | 12180-3205
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Country | US
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Telephone | 518-274-0701
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Fax | 518-274-7944
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Provider Business Mailing Address
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Address Line | 15 3RD ST
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City | TROY
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State | NY
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Zip | 12180-3205
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Country | US
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Telephone | 518-274-0701
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Fax | 518-274-7944
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DENISE ANN FIGUEROA
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Credential |
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Telephone | 518-274-0701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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