33D2178913 CLIA NUMBER - MONTE NIDO GLEN COVE

Laboratory Demographics

CLIA Number: 33D2178913

Facility Name: MONTE NIDO GLEN COVE

Facility Address:
1 SAINT ANDREW'S LANE
GLEN COVE, NY
ZIP 11542
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Facility Phone Number: 516 801-3140

Facility Type: Other - RES FOR EATING DISORDERS

Certificate Type: Waiver

NPI Number: 1457825135

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	33D2178913
LAB Type	Other - RES FOR EATING DISORDERS
Facility Name	MONTE NIDO GLEN COVE
Street	1 SAINT ANDREW'S LANE
City	GLEN COVE
State	NY
ZIP	11542
Phone	516 801-3140
CertificateType	4
CertificateEffectiveDate	2/11/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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This page was last updated on: 4/23/2024