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General NPI Number Information
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NPI Number | 1639372477
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Entity Type | Organization
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Legal Business Name | ST. LAWRENCE COUNTY CDP
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 COMMERCE LN
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City | CANTON
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State | NY
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Zip | 13617-3740
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Country | US
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Telephone | 315-386-1102
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Fax | 315-386-1454
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Provider Business Mailing Address
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Address Line | 1 COMMERCE LN
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City | CANTON
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State | NY
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Zip | 13617-3740
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Country | US
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Telephone | 315-386-1102
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Fax | 315-386-1454
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NORMA S CARY
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Credential |
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Telephone | 315-386-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7008L002L003L004
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License Number State | NY
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