Provider Demographics
NPI:1225400187
Name:SENECA ONTARIO COMMUNITY SERVICE
Entity Type:Organization
Organization Name:SENECA ONTARIO COMMUNITY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-568-9412
Mailing Address - Street 1:12 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-1437
Mailing Address - Country:US
Mailing Address - Phone:315-568-9412
Mailing Address - Fax:315-568-6718
Practice Address - Street 1:12 NORTH PARK STREET
Practice Address - Street 2:SENECA ONTARIO COMMUNITY SERVICES
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148
Practice Address - Country:US
Practice Address - Phone:315-568-9412
Practice Address - Fax:315-568-6718
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELMIRA PSYCHIATRIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3570148A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health