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General NPI Number Information
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NPI Number | 1649445958
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Entity Type | Organization
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Legal Business Name | LASALLE SCHOOL
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 391 WESTERN AVE
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City | ALBANY
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State | NY
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Zip | 12203-1401
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Country | US
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Telephone | 518-242-4731
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Fax | 518-242-4744
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Provider Business Mailing Address
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Address Line | 391 WESTERN AVE
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City | ALBANY
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State | NY
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Zip | 12203-1401
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Country | US
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Telephone | 518-242-4731
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Fax | 518-242-4744
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Authorized Official
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Title or Position | ASSOCIATE EXECUTIVE DIRECTOR
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Name | ANDREW JOSLIN
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Credential |
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Telephone | 518-242-4731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 00A01186
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License Number State | NY
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