Provider Demographics
NPI:1477084341
Name:CANTON ENRICHED HOUSING PROGRAM, INC
Entity Type:Organization
Organization Name:CANTON ENRICHED HOUSING PROGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-386-8830
Mailing Address - Street 1:37 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1064
Mailing Address - Country:US
Mailing Address - Phone:315-386-8830
Mailing Address - Fax:
Practice Address - Street 1:37 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1064
Practice Address - Country:US
Practice Address - Phone:315-386-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management