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General NPI Number Information
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NPI Number | 1689866824
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Entity Type | Organization
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Legal Business Name | OPPORTUNITIES NORTH, LLC
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Dates
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Enumeration Date | 08/12/2007
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Last Update Date | 08/12/2007
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Provider Practice Location Address
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Address Line | 2741 STATE ROUTE 9
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City | LAKE GEORGE
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State | NY
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Zip | 12845-6304
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Country | US
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Telephone | 518-668-4353
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Fax | 518-668-2241
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Provider Business Mailing Address
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Address Line | 444 DIXON RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-1959
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Country | US
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Telephone | 518-668-4353
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Fax | 518-668-2241
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JESSYCA A TOKOS-DARRAH
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Credential |
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Telephone | 518-668-4353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | NY
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