Provider Demographics
NPI:1871190017
Name:WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:SHIPPEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-591-4459
Mailing Address - Street 1:920 LARK DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-1300
Mailing Address - Country:US
Mailing Address - Phone:518-465-4771
Mailing Address - Fax:
Practice Address - Street 1:700 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1404
Practice Address - Country:US
Practice Address - Phone:518-475-6290
Practice Address - Fax:518-475-6291
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITNEY M. YOUNG JR. HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)