Provider Demographics
NPI:1114938594
Name:THE COMMUNITY ACTION ORGANIZATION OF WESTERN NEW YORK, INC.
Entity Type:Organization
Organization Name:THE COMMUNITY ACTION ORGANIZATION OF WESTERN NEW YORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-881-5150
Mailing Address - Street 1:45 JEWETT AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2442
Mailing Address - Country:US
Mailing Address - Phone:716-881-5150
Mailing Address - Fax:716-881-2927
Practice Address - Street 1:1237 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2111
Practice Address - Country:US
Practice Address - Phone:716-884-9101
Practice Address - Fax:716-884-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401208R101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty