ADIRONDACK LEADERSHIP EXPEDITIONS (NPI# 1912202482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912202482 |
| Entity Type | Organization |
| Organization Name | ADIRONDACK LEADERSHIP EXPEDITIONS |
| Practice Address |
82 Church St Saranac Lake NY 12983-1858 |
| Mailing Address |
82 Church St 82 Church Street Saranac Lake NY 12983-1858 |
| Practice Telephone | 5188975011 |
| Practice Fax Number | 5188975017 |
| Mailing Telephone | 5188975011 |
| Mailing Fax Number | 5188975017 |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |
| Authorized Official Name | MR. PATRICK MCAVOY (ADMISSION DIRECTOR) |
| Authorized Official Telephone | 5188975011 |
| Is Organization Subpart | Y |
| Parent Organization Name | CRC HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 162469 | NY | Residential Treatment Facilities |
| Street Address |
82 CHURCH ST |
| City | SARANAC LAKE |
| State | NY |
| Zip Code | 12983-1858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013486315 | Aisha Dominique Wood | Physical Therapist | 2233 Ny-86, Saranac Lake, NY 12983 | 2018-11-15 |
| 1215357132 | Ashley Garwood | Occupational Therapist | 38 Tahoma Road, Saranac Lake, NY 12983 | 2014-04-17 |
| 1841537982 | Dean Everritt | Social Worker | 33 Depot St., Saranac Lake, NY 12983 | 2013-01-09 |
| 1265797013 | Danielle Carr | Counselor | 28 Bernard Street, Saranac Lake, NY 12983 | 2012-07-09 |
| 1275807489 | Deborah Ann Stevens | Licensed Practical Nurse | 157 Bloomingdale Ave Apt 3, Saranac Lake, NY 12983 | 2012-03-06 |
| 1699085910 | Jessica Evans Jakobe | Speech-Language Pathologist | 141 Petrova Ave, Petrova Elementary, Saranac Lake, NY 12983 | 2010-10-20 |
| 1548407562 | Eve M Burns | Obstetrics & Gynecology | 309 County Route 47 Ste 2, Saranac Lake, NY 12983 | 2009-01-13 |
| 1174735492 | Citizen Advocates Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 Shepard Ave Apt. 1, Saranac Lake, NY 12983 | 2007-05-07 |
| 1750442513 | High Peaks Hospice and Palliative Care, Inc. | Hospice Care, Community Based | 309 County Route 47 Ste 7, Saranac Lake, NY 12983 | 2006-12-13 |
| 1467536797 | Clifford Gerard Wagner | Chiropractor | 53 Woodruff Street, Saranac Lake, NY 12983 | 2006-10-24 |
| Find all providers in zip 12983 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013360361 | Jesse Brand | Residential Treatment Facility, Emotionally Disturbed Children | 60 Forrest Ave, Shirley, NY 11967-1955 | 2016-07-21 |
| 1285040600 | Sean Bedford | Residential Treatment Facility, Emotionally Disturbed Children | 7 Scarlett Ct, Apt 16, New City, NY 10956-5030 | 2014-07-07 |
| 1336575703 | Education Plus Corp | Residential Treatment Facility, Emotionally Disturbed Children | 431 Chapel Hill Rd, Hancock, NY 13783-2248 | 2013-09-17 |
| 1578905212 | Jewish Child Care Association | Residential Treatment Facility, Emotionally Disturbed Children | 671 Osborn St, Brooklyn, NY 11212-5745 | 2013-07-23 |
| 1538419973 | Scott Fierman Services | Residential Treatment Facility, Emotionally Disturbed Children | 31 Ohayo Mountain Rd, Woodstock, NY 12498-1441 | 2012-09-13 |
| 1821374448 | Takenya Tanyette Benbow | Residential Treatment Facility, Emotionally Disturbed Children | 135 West 50th Street 6th Floor, Jewish Board of Family and Children Services, New York, NY 10020 | 2011-10-27 |
| 1720377757 | Lidia Kupiec Lmsw | Residential Treatment Facility, Emotionally Disturbed Children | 178 Bradley Rd, Scarsdale, NY 10583-6343 | 2011-03-30 |
| 1891016192 | Access: Supports for Living Inc | Residential Treatment Facility, Emotionally Disturbed Children | 87 Little Britain Rd, Newburgh, NY 12550-5113 | 2010-06-21 |
| 1356675151 | Ohel Childrens Home & Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1498 E 34 St, Brooklyn, NY 11234 | 2009-09-25 |
| 1437385879 | Teaching Family Plainview | Residential Treatment Facility, Emotionally Disturbed Children | 4 Sunrise St, Plainview, NY 11803-4613 | 2009-05-29 |
| Find all providers with the same taxonomy | ||||
| City | SARANAC LAKE |
| Zip Code | 12983 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.