Provider Demographics
NPI:1629228937
Name:STEUBEN CHURCHPEOPLE AGAINST POVERTY
Entity Type:Organization
Organization Name:STEUBEN CHURCHPEOPLE AGAINST POVERTY
Other - Org Name:ARBOR DEVELOPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-776-7664
Mailing Address - Street 1:16 W WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-1531
Mailing Address - Country:US
Mailing Address - Phone:607-776-7664
Mailing Address - Fax:607-776-9118
Practice Address - Street 1:16 W WILLIAM ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1531
Practice Address - Country:US
Practice Address - Phone:607-776-7664
Practice Address - Fax:607-776-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7515430251E00000X
NY7515431251E00000X
NY7515433251E00000X
NY7515435251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01304021Medicaid