| Intensive Case Management Program | |
|
260 South Pearl Street Albany NY 12202-2011 | |
| (518) 447-4555 | |
| (518) 447-4661 |
| Full Name | Intensive Case Management Program |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 260 South Pearl Street, Albany, New York |
| Authorized Official Name and Position | Robin E Siegal (DIRECTOR) |
| Authorized Official Contact | 5184474537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intensive Case Management Program 175 Green Street Albany NY 12202-2011 Ph: (518) 447-4537 | Intensive Case Management Program 260 South Pearl Street Albany NY 12202-2011 Ph: (518) 447-4555 |
| NPI Number | 1952460990 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952460990 | NPI | - | NPPES |
| 01167188 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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