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General NPI Number Information
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NPI Number | 1073065561
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Entity Type | Organization
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Legal Business Name | FAMILY SUPPORT IN CENTRAL NEW YORK, INC.
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 155 MADISON ST
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City | ONEIDA
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State | NY
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Zip | 13421-1743
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Country | US
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Telephone | 315-941-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 9582 WHITTAKER RD
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City | HOLLAND PATENT
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State | NY
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Zip | 13354-4343
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Country | US
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Telephone | 315-794-5799
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Fax | 315-768-3670
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Authorized Official
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Title or Position | FAMILY PEER ADVOCATE
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Name | JOAN A GODLEWSKI
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Credential |
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Telephone | 315-794-4590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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