Provider Demographics
NPI:1114364544
Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Other - Org Name:EARLY INTERVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:EIO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-268-9767
Mailing Address - Street 1:7 COURT ST COUNTY OFFICE COMPLEX
Mailing Address - Street 2:GROUND FLOOR RM 13
Mailing Address - City:BELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:14813
Mailing Address - Country:US
Mailing Address - Phone:585-268-9767
Mailing Address - Fax:
Practice Address - Street 1:7 COURT STREET COUNTY OFFICE COMPLEX
Practice Address - Street 2:GROUND FLOOR ROOM 13
Practice Address - City:BELMONT
Practice Address - State:NY
Practice Address - Zip Code:14813-1044
Practice Address - Country:US
Practice Address - Phone:585-268-9767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02960974Medicaid