Indian Lake Csd

LBN: Indian Lake Csd
Indian Lake Csd is an health care organization with primary practice located at 28 W Main St , Indian Lake NY 12842-1500. The organization recently has only one registered license in Agencies / Local Education Agency (LEA), which is considered as the primary health care specialty. Indian Lake Csd can be contacted via phone (518) 648-5024, or through Brand, Mark T via phone (518) 648-5024.

Contact Information

Primary practice address
28 W Main St Indian Lake NY 12842-1500
Phone: (518) 648-5024
Fax: (518) 648-6346
Website:
Map and Directions
Authorized official contact:
Name: Brand, Mark T
Phone: (518) 648-5024

Health care specialties

SpecialtyCodeLicense #State
Agencies / Local Education Agency (LEA) 251300000X

Profile Details

NPI number 1841344017
LBN Legal business name Indian Lake Csd
DBA Doing business as
Authorized official Brand, Mark T
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 2007
Last updated Mar 18th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841344017 NPPES
New York MEDICAID 01382301

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