Provider Demographics
NPI:1225701352
Name:NYS DOCCS COLLINS CORRECTIONAL FACILITY
Entity Type:Organization
Organization Name:NYS DOCCS COLLINS CORRECTIONAL FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LATONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-532-4588
Mailing Address - Street 1:MIDDLE ROAD
Mailing Address - Street 2:PO BOX 490
Mailing Address - City:COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14034-0490
Mailing Address - Country:US
Mailing Address - Phone:716-532-4588
Mailing Address - Fax:
Practice Address - Street 1:MIDDLE ROAD
Practice Address - Street 2:490
Practice Address - City:COLLINS
Practice Address - State:NY
Practice Address - Zip Code:14034-0490
Practice Address - Country:US
Practice Address - Phone:716-532-4588
Practice Address - Fax:716-532-6306
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTMENT OF CORRECTIONS & COMMUNITY SUPERVISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility