Healthcare Provider Details

I. General information

NPI: 1780756114
Provider Name (Legal Business Name): DEPAUL COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MT. HOPE AVENUE
ROCHESTER NY
14620-1016
US

IV. Provider business mailing address

1931 BUFFALO ROAD
ROCHESTER NY
14624-1535
US

V. Phone/Fax

Practice location:
  • Phone: 585-426-8000
  • Fax: 585-429-5211
Mailing address:
  • Phone: 585-426-8000
  • Fax: 585-719-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES M. WHALEN
Title or Position: CFO
Credential:
Phone: 585-719-3170