Healthcare Provider Details

I. General information

NPI: 1265816656
Provider Name (Legal Business Name): SCHOHARIE COUNTY COMMUNITY ACTION PROGRAM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EAST MAIN STREET SUITE 5
COBLESKILL NY
12043
US

IV. Provider business mailing address

795 EAST MAIN STREET SUITE 5
COBLESKILL NY
12043
US

V. Phone/Fax

Practice location:
  • Phone: 518-234-2568
  • Fax: 518-234-3507
Mailing address:
  • Phone: 518-234-2568
  • Fax: 518-234-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. JEANNETTE M SPAULDING
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 518-234-2568