Provider Demographics
NPI:1689869042
Name:VANDERHEYDEN HALL, INC.
Entity Type:Organization
Organization Name:VANDERHEYDEN HALL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAPPES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:518-283-6500
Mailing Address - Street 1:614 COOPER HILL RD
Mailing Address - Street 2:ROUTE 355
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198-2906
Mailing Address - Country:US
Mailing Address - Phone:518-283-6500
Mailing Address - Fax:518-283-3013
Practice Address - Street 1:614 COOPER HILL RD
Practice Address - Street 2:ROUTE 355
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-2906
Practice Address - Country:US
Practice Address - Phone:518-283-6500
Practice Address - Fax:518-283-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02003996Medicaid