Provider Demographics
NPI:1467527283
Name:HOME AIDES OF CENTRAL NEW YORK, INC.
Entity Type:Organization
Organization Name:HOME AIDES OF CENTRAL NEW YORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLF
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CHCE, FACHE
Authorized Official - Phone:315-477-9595
Mailing Address - Street 1:1050 WEST GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204
Mailing Address - Country:US
Mailing Address - Phone:315-477-4663
Mailing Address - Fax:315-477-9378
Practice Address - Street 1:1050 WEST GENESEE STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204
Practice Address - Country:US
Practice Address - Phone:315-477-4663
Practice Address - Fax:315-477-9378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6027L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00588023Medicaid
NY56263BMedicare UPIN
NY00588023Medicaid