Provider Demographics
NPI:1689866824
Name:OPPORTUNITIES NORTH, LLC
Entity Type:Organization
Organization Name:OPPORTUNITIES NORTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSYCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOKOS-DARRAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-668-4353
Mailing Address - Street 1:444 DIXON RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1959
Mailing Address - Country:US
Mailing Address - Phone:518-668-4353
Mailing Address - Fax:518-668-2241
Practice Address - Street 1:2741 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:LAKE GEORGE
Practice Address - State:NY
Practice Address - Zip Code:12845-6304
Practice Address - Country:US
Practice Address - Phone:518-668-4353
Practice Address - Fax:518-668-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care