Provider Demographics
NPI:1750453148
Name:THE DANFORTH ADULT CARE CENTER
Entity type:Organization
Organization Name:THE DANFORTH ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-686-5167
Mailing Address - Street 1:19 DANFORTH ST
Mailing Address - Street 2:
Mailing Address - City:HOOSICK FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12090-1223
Mailing Address - Country:US
Mailing Address - Phone:518-686-5167
Mailing Address - Fax:518-686-4428
Practice Address - Street 1:19 DANFORTH ST
Practice Address - Street 2:
Practice Address - City:HOOSICK FALLS
Practice Address - State:NY
Practice Address - Zip Code:12090-1223
Practice Address - Country:US
Practice Address - Phone:518-686-5167
Practice Address - Fax:518-686-4428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCJD8027344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02771662Medicaid