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General NPI Number Information
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NPI Number | 1942495304
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Entity Type | Organization
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Legal Business Name | VANDERHEYDEN HALL, INC.
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 614 COOPER HILL RD ROUTE 355
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City | WYNANTSKILL
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State | NY
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Zip | 12198-2906
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Country | US
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Telephone | 518-283-6500
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Fax | 518-283-3013
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Provider Business Mailing Address
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Address Line | 614 COOPER HILL RD ROUTE 355
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City | WYNANTSKILL
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State | NY
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Zip | 12198-2906
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Country | US
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Telephone | 518-283-6500
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Fax | 518-283-3013
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LINDA B MAPPES
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Credential | MSW
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Telephone | 518-283-6500
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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 | R8676430
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License Number State | NY
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