Healthcare Provider Details

I. General information

NPI: 1437340064
Provider Name (Legal Business Name): ORLEANS COUNTY CHAPTER NYSARC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 CAROLINE ST
ALBION NY
14411-1006
US

IV. Provider business mailing address

122 CAROLINE ST PO BOX 439
ALBION NY
14411-1006
US

V. Phone/Fax

Practice location:
  • Phone: 585-589-5516
  • Fax: 585-589-5669
Mailing address:
  • Phone: 585-589-5516
  • Fax: 585-589-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DONALD COLQUHOUN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 585-589-5516