Mountain Lake Services
LBN: Essex County Chapter, Nysarc, Inc.
Mountain Lake Services is an health care organization with primary practice located at 10 St. Patrick'S Place , Port Henry NY 12974. The organization recently has 2 registered licenses in different health care specialties including Agencies / Early Intervention Provider Agency, Ambulatory Health Care Facilities / Developmental Disabilities. Agencies / Early Intervention Provider Agency is the primary health care specialty.
Essex County Chapter, Nysarc, Inc. can be contacted via phone (518) 546-3051, or through Nephew, Martin Joseph via phone (518) 546-3381.
Contact Information
Primary practice address
10 St. Patrick'S Place
Port Henry NY 12974
Phone: (518) 546-3051
Fax: (518) 546-3094
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Early Intervention Provider Agency | 252Y00000X | 150901880216 | New York |
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X | New York |
Profile Details
| NPI number | 1427134451 |
|---|---|
| LBN Legal business name | Essex County Chapter, Nysarc, Inc. |
| DBA Doing business as | Mountain Lake Services |
| Authorized official | Nephew, Martin Joseph |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Mar 23rd, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427134451 | NPPES |
| New York | Other | 6763301 | OPERATING CERTIFICATE # |
| New York | MEDICAID | 01276842 | OPERATING CERTIFICATE # |
| New York | Other | 03 | OPERATING CERTIFICATE # |
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