Healthcare Provider Details

I. General information

NPI: 1437333879
Provider Name (Legal Business Name): OSWEGO COUNTY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SPRING STREET
MEXICO NY
13114
US

IV. Provider business mailing address

70 BUNNER ST
OSWEGO NY
13126-3357
US

V. Phone/Fax

Practice location:
  • Phone: 315-963-5014
  • Fax: 315-963-5530
Mailing address:
  • Phone: 315-349-8347
  • Fax: 315-349-3234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number00317359
License Number StateNY

VIII. Authorized Official

Name: MS. FRANCES V LANIGAN
Title or Position: COMMISSIONER OF SOCIAL SERVICES
Credential:
Phone: 315-963-5000