Healthcare Provider Details

I. General information

NPI: 1730256322
Provider Name (Legal Business Name): CORTLAND COUNTY HEALTH DEPT CHILDREN WITH SPECIAL NEEDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CENTRAL AVE CORTLAND COUNTY HEALTH DEPARTMENT
CORTLAND NY
13045-2746
US

IV. Provider business mailing address

60 CENTRAL AVE CORTLAND COUNTY HEALTH DEPARTMENT
CORTLAND NY
13045-2746
US

V. Phone/Fax

Practice location:
  • Phone: 607-753-5135
  • Fax: 607-753-5209
Mailing address:
  • Phone: 607-753-5135
  • Fax: 607-753-5209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHERINE FEUERHERM
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: RN, MSN, NP
Phone: 607-753-5135