Provider Demographics
NPI:1477672798
Name:AIDS COMMUNITY RESOURCES, INC
Entity Type:Organization
Organization Name:AIDS COMMUNITY RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-475-2430
Mailing Address - Street 1:627 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2341
Mailing Address - Country:US
Mailing Address - Phone:315-475-2430
Mailing Address - Fax:315-472-6515
Practice Address - Street 1:627 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2341
Practice Address - Country:US
Practice Address - Phone:315-475-2430
Practice Address - Fax:315-472-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01272031Medicaid