| Samaritan Daytop Village, Inc. | |
|
55 W 125th St 10th Floor New York NY 10027-4516 | |
| (212) 864-4128 | |
| (212) 662-9193 |
| Full Name | Samaritan Daytop Village, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 55 W 125th St, New York, New York |
| Authorized Official Name and Position | Charles Madray (VP OF HEALTH SERVICES & COMMUNITY B) |
| Authorized Official Contact | 7182062000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Daytop Village, Inc. 55 W 125th St 10th Floor New York NY 10027-4516 Ph: (212) 864-4128 | Samaritan Daytop Village, Inc. 55 W 125th St 10th Floor New York NY 10027-4516 Ph: (212) 864-4128 |
| NPI Number | 1043619349 |
|---|---|
| Provider Enumeration Date | 08/22/2014 |
| Last Update Date | 04/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043619349 | NPI | - | NPPES |
| 139682283 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 00245309 (New York) | Primary |
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