Healthcare Provider Details

I. General information

NPI: 1841857471
Provider Name (Legal Business Name): BADEN STREET SETTLEMENT OF ROCHESTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N CLINTON AVE
ROCHESTER NY
14605-1811
US

IV. Provider business mailing address

152 BADEN ST
ROCHESTER NY
14605-2054
US

V. Phone/Fax

Practice location:
  • Phone: 585-445-6780
  • Fax: 585-232-1393
Mailing address:
  • Phone: 585-445-6718
  • Fax: 585-546-3777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: RON THOMAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 585-445-6718