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General NPI Number Information
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NPI Number | 1558579052
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Entity Type | Organization
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Legal Business Name | JOSHUA HOUSE INC.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 DIVISION STREET
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City | SIDNEY
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State | NY
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Zip | 13838
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Country | US
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Telephone | 607-563-3994
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Fax | 607-563-9936
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Provider Business Mailing Address
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Address Line | PO BOX 387
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City | SIDNEY CENTER
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State | NY
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Zip | 13839-0387
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Country | US
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Telephone |
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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 | MR. RUSSELL ALVAREZ
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Credential |
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Telephone | 607-563-3994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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