Provider Demographics
NPI:1588602064
Name:COUNTY OF GENESEE COUNTY TREASURER
Entity Type:Organization
Organization Name:COUNTY OF GENESEE COUNTY TREASURER
Other - Org Name:GENESEE COUNTY MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:585-344-1421
Mailing Address - Street 1:5130 EAST MAIN STREET ROAD
Mailing Address - Street 2:STE 2
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3496
Mailing Address - Country:US
Mailing Address - Phone:585-344-1421
Mailing Address - Fax:585-344-3047
Practice Address - Street 1:5130 EAST MAIN STREET ROAD
Practice Address - Street 2:STE 2
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3496
Practice Address - Country:US
Practice Address - Phone:585-344-1421
Practice Address - Fax:585-344-3047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00357497Medicaid
NY01165017Medicaid
NY01333068Medicaid
NY063523Medicare PIN