JEFFERSON REHABILITATION CENTER NPI 1699982603

NPI Information

NPI: 1699982603
Provider Name: JEFFERSON REHABILITATION CENTER
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
453 GAFFNEY DR
WATERTOWN, NY
ZIP 13601
Phone: (315) 788-3719
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JEFFERSON REHABILITATION CENTER is an intermediate care facility mentally retarded in Watertown, NY. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. JEFFERSON REHABILITATION CENTER NPI is 1699982603. The provider is registered as an organization entity type.

The provider's business location address is:

453 GAFFNEY DR
WATERTOWN, NY
ZIP 13601-834
Phone: (315) 788-3719

The provider's authorized official is Daniel E. Stern .
The authorized official title is Executive Director and has the following contact phone number (315) 788-2730.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 8/22/2020.

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	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		7642494	NEW YORK	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	01289610	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: 4/28/2024

NPI Synchronization or Removal

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