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General NPI Number Information
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NPI Number | 1922471101
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Entity Type | Organization
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Legal Business Name | ST. LAWRENCE PSYCHIATRIC CENTER
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 1 CHIMNEY POINT DR
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City | OGDENSBURG
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State | NY
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Zip | 13669-2212
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Country | US
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Telephone | 315-541-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHIMNEY POINT DR
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City | OGDENSBURG
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State | NY
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Zip | 13669-2212
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Country | US
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Telephone | 315-541-2210
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Fax |
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Authorized Official
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Title or Position | LPN, MOBILE INTEGRATION TEAM
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Name | MS. JENNIFER E WOODS
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Credential | LPN
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Telephone | 315-541-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 278784
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License Number State | NY
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