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General NPI Number Information
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NPI Number | 1235116286
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF UPSTATE NEW YORK, INC.
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 715 FALCONER ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-1935
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Country | US
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Telephone | 716-665-4905
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Fax | 716-665-8132
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Provider Business Mailing Address
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Address Line | 715 FALCONER ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-1935
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Country | US
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Telephone | 716-665-4905
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Fax | 716-665-8132
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | MELISSA NURMI
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Credential |
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Telephone | 716-665-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0602308ZN
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License Number State | NY
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