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General NPI Number Information
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NPI Number | 1639567522
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Entity Type | Organization
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Legal Business Name | VALLEY RESIDENTIAL SERVICES, INC.
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Dates
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Enumeration Date | 12/31/2014
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 690 W GERMAN ST
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City | HERKIMER
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State | NY
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Zip | 13350-2135
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Country | US
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Telephone | 315-866-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 161 VALLEY DR.
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City | HERKIMER
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State | NY
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Zip | 13350
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Country | US
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Telephone | 315-219-5700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LISA M. BETRUS
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Credential |
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Telephone | 315-866-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NY
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