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NPI Code Detail

MEDICARE: DEPAUL COMMUNITY SERVICES INC

MEDICARE: DEPAUL COMMUNITY SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780756114
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPAUL COMMUNITY SERVICES INC
Provider Business Mailing Address
First Line : 1931 BUFFALO ROAD
Second Line :
City : ROCHESTER
State : NY
Zip : 14624-1535
Country : US
Telephone Number : 585-426-8000
Fax Number : 585-719-3183
Provider Business Practice Location Address
First Line : 150 MT. HOPE AVENUE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1016
Country : US
Telephone Number : 585-426-8000
Fax Number : 585-429-5211
Authorized Official
Title or Position : CFO
Name : MR. JAMES M. WHALEN
Credential :
Telephone Number : 585-719-3170
Provider Enumeration Date : 11/14/2006
Last Update Date : 09/06/2011

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Directions to “DEPAUL COMMUNITY SERVICES INC ” Practice Location

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