Provider Demographics
NPI:1649333485
Name:UNITY HOUSE OF TROY INC
Entity type:Organization
Organization Name:UNITY HOUSE OF TROY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAULISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-274-2607
Mailing Address - Street 1:2431 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2227
Mailing Address - Country:US
Mailing Address - Phone:518-274-2607
Mailing Address - Fax:518-274-7776
Practice Address - Street 1:33 2ND ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3904
Practice Address - Country:US
Practice Address - Phone:518-274-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
NY343900000X, 320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No252Y00000XAgenciesEarly Intervention Provider Agency
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01325497Medicaid
NY02722269Medicaid
NY02706036Medicaid
NY02821474Medicaid