Provider Demographics
NPI:1578615423
Name:HOSPITALITY HOUSE TC, INC.
Entity Type:Organization
Organization Name:HOSPITALITY HOUSE TC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:R
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CASAC
Authorized Official - Phone:518-434-6468
Mailing Address - Street 1:271 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2611
Mailing Address - Country:US
Mailing Address - Phone:518-434-6468
Mailing Address - Fax:518-434-6302
Practice Address - Street 1:271 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2611
Practice Address - Country:US
Practice Address - Phone:518-434-6468
Practice Address - Fax:518-434-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061210043324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility