Healthcare Provider Details

I. General information

NPI: 1821272972
Provider Name (Legal Business Name): CAYUGA HOME FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 07/26/2023
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HAMILTON AVE
AUBURN NY
13021-5028
US

IV. Provider business mailing address

101 HAMILTON AVE
AUBURN NY
13021-5028
US

V. Phone/Fax

Practice location:
  • Phone: 315-253-5383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRANJESKA CAIMARES
Title or Position: MEDICAID LIAISON
Credential:
Phone: 646-906-4796