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General NPI Number Information
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NPI Number | 1689990632
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Entity Type | Organization
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Legal Business Name | GREATER BINGHAMTON HEALTH CENTER
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 425 ROBINSON ST
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City | BINGHAMTON
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State | NY
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Zip | 13904-1735
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Country | US
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Telephone | 607-763-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 425 ROBINSON ST
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City | BINGHAMTON
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State | NY
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Zip | 13904-1735
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Country | US
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Telephone | 607-763-2722
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MRS. KARIE LYNN WILCOX
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Credential |
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Telephone | 607-763-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | NY
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