1982709846 NPI number — COUNTY OF STEUBEN

Table of content: (NPI 1982709846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982709846 NPI number — COUNTY OF STEUBEN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF STEUBEN
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:
STEUBEN COUNTY COMMUNITY SERVICES - MH
Provider Other Organization Name Type Code:
5
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:
1982709846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 LIBERTY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14810-1508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-664-2255
Provider Business Mailing Address Fax Number:
607-664-2162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 LIBERTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14810-1508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-664-2255
Provider Business Practice Location Address Fax Number:
607-664-2162
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAPMAN
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
DIRECTOR OF COMMUNITY SERVICES
Authorized Official Telephone Number:
607-664-2255

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CA2584 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 105427EU . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112630100 . This is a "ACS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7342561 . This is a "NYSHIP/VO/RR/FHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000426563 . This is a "UNIVERA MH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7342561 . This is a "GHI/BMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00357488 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000159861 . This is a "BCBS MH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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