OrganizationActive
State of New York
NPI 1376683367 · Intellectual Disabilities Intermediate Care Facility · Celeron, NY
Provider details
- NPI number
- 1376683367
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- State of New York
- Organization subpart
- Yes
- Authorized official
- Karla Smith, Director of Central Operations(518) 402-4333
- License
- 00264040 (NY)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
27a Gifford Ave
Celeron, NY 14720
Phone: (518) 402-4333
Street-level locationGet directions
Mailing address
44 Holland Ave
Albany, NY 12229-0001
Other names (DBA / former)
- Other name
- Western Ny Ddso Gifford Ave a
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2008-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.