Provider Demographics
NPI:1265635551
Name:ACCESSCNY, INC.
Entity Type:Organization
Organization Name:ACCESSCNY, INC.
Other - Org Name:TRANSITIONAL LIVING SERVICES ONONDAGA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PRUDENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-455-7591
Mailing Address - Street 1:1603 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208
Mailing Address - Country:US
Mailing Address - Phone:315-455-7591
Mailing Address - Fax:315-478-3118
Practice Address - Street 1:1603 COURT STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208
Practice Address - Country:US
Practice Address - Phone:315-478-4151
Practice Address - Fax:315-478-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01309897Medicaid