Provider Demographics
NPI:1285027458
Name:CATHOLIC CHARITIES OF CHENANGO COUNTY
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF CHENANGO COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-334-8244
Mailing Address - Street 1:3 OHARA DR
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-2046
Mailing Address - Country:US
Mailing Address - Phone:607-334-8244
Mailing Address - Fax:607-336-5779
Practice Address - Street 1:3 OHARA DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-2046
Practice Address - Country:US
Practice Address - Phone:607-334-8244
Practice Address - Fax:607-336-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7893430320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1447318662Medicaid