Provider Demographics
NPI:1477857209
Name:LUTHERAN SOCIAL SERVICES OF UPSTATE NEW YORK, INC.
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF UPSTATE NEW YORK, INC.
Other - Org Name:WARNER PLACE ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-665-8137
Mailing Address - Street 1:715 FALCONER ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-1935
Mailing Address - Country:US
Mailing Address - Phone:814-665-8137
Mailing Address - Fax:814-665-8132
Practice Address - Street 1:715 FALCONER ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-1935
Practice Address - Country:US
Practice Address - Phone:814-665-8137
Practice Address - Fax:814-665-8132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SOCIAL SERVICES GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care