Provider Demographics
NPI:1669839007
Name:SENIOR CITIZENS COUNCIL OF ROME NY INC.
Entity Type:Organization
Organization Name:SENIOR CITIZENS COUNCIL OF ROME NY INC.
Other - Org Name:AVA DORFMAN SENIOR CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-337-8230
Mailing Address - Street 1:305 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-3508
Mailing Address - Country:US
Mailing Address - Phone:315-337-8230
Mailing Address - Fax:315-709-0287
Practice Address - Street 1:305 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-3508
Practice Address - Country:US
Practice Address - Phone:315-337-8230
Practice Address - Fax:315-709-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care