Provider Demographics
NPI:1073955092
Name:MENTAL HEALTH ASSOCIATION OF THE SOUTHERN TIER, INC.
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF THE SOUTHERN TIER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-771-8888
Mailing Address - Street 1:47 BROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904
Mailing Address - Country:US
Mailing Address - Phone:607-771-8888
Mailing Address - Fax:607-771-8892
Practice Address - Street 1:47 BROAD AVENUE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904
Practice Address - Country:US
Practice Address - Phone:607-771-8888
Practice Address - Fax:607-771-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable