Provider Demographics
NPI:1316302284
Name:LASALLE SCHOOL
Entity type:Organization
Organization Name:LASALLE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YETTRU
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:518-242-4731
Mailing Address - Street 1:391 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1401
Mailing Address - Country:US
Mailing Address - Phone:518-242-4731
Mailing Address - Fax:518-242-4747
Practice Address - Street 1:391 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1401
Practice Address - Country:US
Practice Address - Phone:518-242-4731
Practice Address - Fax:518-242-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health