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General NPI Number Information
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NPI Number | 1457469876
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Entity Type | Organization
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Legal Business Name | SARATOGA COUNTY
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Dates
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Enumeration Date | 08/26/2006
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 149 BALLSTON AVENUE
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City | BALLSTON SPA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-885-2288
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Fax | 518-885-2221
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Provider Business Mailing Address
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Address Line | 149 BALLSTON AVENUE
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City | BALLSTON SPA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-885-2288
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Fax | 518-885-2221
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DIANE L BROWN
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Credential |
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Telephone | 518-885-2218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 4520301N
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License Number State | NY
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