Healthcare Provider Details

I. General information

NPI: 1104030261
Provider Name (Legal Business Name): RESOURCE CENTER FOR INDEPENDENT LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 GENESEE ST
UTICA NY
13501-2105
US

IV. Provider business mailing address

131 GENESEE ST PO BOX 210
UTICA NY
13501-0210
US

V. Phone/Fax

Practice location:
  • Phone: 315-797-4642
  • Fax: 315-797-4747
Mailing address:
  • Phone: 315-797-4642
  • Fax: 315-797-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ZVIA MCCORMICK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 315-797-4642