Provider Demographics
NPI:1205834801
Name:ONTARIO COUNTY COUNTY TREAS
Entity Type:Organization
Organization Name:ONTARIO COUNTY COUNTY TREAS
Other - Org Name:ONTARIO COUNTY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-394-4354
Mailing Address - Street 1:3019 COUNTY COMPLEX DR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9505
Mailing Address - Country:US
Mailing Address - Phone:585-396-4997
Mailing Address - Fax:585-396-4313
Practice Address - Street 1:3019 COUNTY COMPLEX DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9505
Practice Address - Country:US
Practice Address - Phone:585-396-4997
Practice Address - Fax:585-396-4313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3429600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103317CIOtherPREFERRED CARE
NYP010103735OtherEXCELLUS
NY00355853Medicaid
NY103317CIOtherPREFERRED CARE
NY00355853Medicaid