1124025705 NPI number — COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124025705 NPI number — COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124025705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
452 DELAWARE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14202-1515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-883-8888
Provider Business Mailing Address Fax Number:
716-883-2065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
452 DELAWARE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14202-1515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-883-8888
Provider Business Practice Location Address Fax Number:
716-883-2065
Provider Enumeration Date:
06/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FOLEY
Authorized Official First Name:
MARK
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
716-883-8888

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251C00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01492135 . This is a "IRE WAIVER DAY HABILITATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01997699 . This is a "NON-WAIVE/ISS SERVICE COO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02591739 . This is a "WAIVER HOURLY RESPITE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02171846 . This is a "WAIVER SUPPORTIVE EMPLOYM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01997699 . This is a "WAIVER MSC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02161508 . This is a "GROUP & INDIVIDUAL FAMILY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01492135 . This is a "WAIVER/HCBS RESIDENTIAL H" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01750334 . This is a "1377 ABBOTT RD DAY HABILI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01750334 . This is a "ISE WAIVER RESIDENTAIL HA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02161508 . This is a "ACT WAIVER DAY HABILITATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01492135 . This is a "SENIOR DAY WAIVER DAY HAB" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01750334 . This is a "PACT WAIVER RESIDENTIAL H" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02253469 . This is a "WAIVER SERVICE IRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02588663 . This is a "WAIVER BAKOS IRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01750334 . This is a "1845 GENESEE NON DD DAY H" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01492135 . This is a "WAIVER/HCBS DAY HABILITAT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02253487 . This is a "WAIVER SUPPORTIVE IRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02599833 . This is a "WAIVER LAKE IRA" identifier . This identifiers is of the category "OTHER".




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