ST JOSEPHS REHABILITATION CENTER INC NPI 1629172762

NPI Information

NPI: 1629172762
Provider Name: ST JOSEPHS REHABILITATION CENTER, INC

Doing Business As: ST JOSEPHS ADDICTION TREATMENT & RECOVERY CENTERS

Classification: Rehabilitation Hospital - 283X00000X
Entity Type: Organization

Address:
159 GLENWOOD DR
SARANAC LAKE, NY
ZIP 12983
Phone: (518) 891-3950
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ST JOSEPHS REHABILITATION CENTER, INC is a rehabilitation hospital in Saranac Lake, NY. The provider is a hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. ST JOSEPHS REHABILITATION CENTER, INC NPI is 1629172762. The provider is registered as an organization entity type.
The provider Is Doing Business As St Josephs Addiction Treatment & Recovery Centers.

The provider's business location address is:

159 GLENWOOD DR
SARANAC LAKE, NY
ZIP 12983-385
Phone: (518) 891-3950
Fax: (518) 891-6134

The provider's authorized official is Zachary Randolph .
The authorized official title is Ceo and has the following contact phone number (518) 891-3950.

The CLIA number assigned to this NPI record is 33D2162138 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 1/31/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
2	276400000X	Rehabilitation, Substance Use Disorder Unit		No
3	324500000X	Substance Abuse Rehabilitation Facility		No
4	251S00000X	Community/Behavioral Health		No
5	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	No
6	283X00000X	Rehabilitation Hospital		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00689758	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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