Provider Demographics
NPI:1528564887
Name:NYSARC, INC. CATTARAUGUS-NIAGARA COUNTY CHAPTER
Entity Type:Organization
Organization Name:NYSARC, INC. CATTARAUGUS-NIAGARA COUNTY CHAPTER
Other - Org Name:NYSARC, INC. CATTARAUGUS COUNTY CHAPTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:THREEHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-375-4747
Mailing Address - Street 1:1439 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 MEAD ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-4408
Practice Address - Country:US
Practice Address - Phone:716-375-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities