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General NPI Number Information
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NPI Number | 1467432765
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Entity Type | Organization
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Legal Business Name | UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC.
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 4 COMMERCE LN
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City | CANTON
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State | NY
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Zip | 13617-3739
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Country | US
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Telephone | 315-386-1156
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Fax | 315-379-9388
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Provider Business Mailing Address
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Address Line | 4 COMMERCE LN
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City | CANTON
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State | NY
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Zip | 13617-3739
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Country | US
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Telephone | 315-386-1156
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Fax | 315-379-9388
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ALEXANDER BRYDEN
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Credential |
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Telephone | 315-379-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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