Healthcare Provider Details
I. General information
NPI: 1013256395
Provider Name (Legal Business Name): ECHO DAY COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2013
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 PRYOR AVE
TONAWANDA NY
14150-7431
US
IV. Provider business mailing address
190 MINERVA ST
TONAWANDA NY
14150-3336
US
V. Phone/Fax
- Phone: 716-833-2851
- Fax:
- Phone: 716-833-2851
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHRYN
T
CORASANTI
Title or Position: PROGRAM DIRECTOR
Credential: M.H.A.
Phone: 716-946-1122