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General NPI Number Information
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NPI Number | 1245543610
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Entity Type | Organization
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Legal Business Name | CHAUTAUQUA COUNTY DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 7 N ERIE ST HALL R. CLOTHIER BUILDING
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City | MAYVILLE
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State | NY
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Zip | 14757-1090
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Country | US
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Telephone | 716-753-4312
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Fax |
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Provider Business Mailing Address
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Address Line | 7 N ERIE ST HALL R. CLOTHIER BUILDING
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City | MAYVILLE
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State | NY
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Zip | 14757-1090
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Country | US
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Telephone | 716-753-4312
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Fax |
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Authorized Official
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Title or Position | E.I. SERVICE COORDINATOR
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Name | JENNIFER SUSAN JOHNSON
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Credential | R.N.
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Telephone | 716-753-4786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 490281
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License Number State | NY
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