Provider Demographics
NPI:1710024120
Name:TOOMEY RESIDENTIAL AND COMMUNITY SERVICES CORP.
Entity Type:Organization
Organization Name:TOOMEY RESIDENTIAL AND COMMUNITY SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:D'AMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-424-1845
Mailing Address - Street 1:1654 W ONONDAGA ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-3310
Mailing Address - Country:US
Mailing Address - Phone:315-424-1845
Mailing Address - Fax:315-424-7567
Practice Address - Street 1:733 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2538
Practice Address - Country:US
Practice Address - Phone:315-424-1845
Practice Address - Fax:315-424-7567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
NY8686440315P00000X
NY8686441315P00000X
NY8234430320800000X
NY8686442320900000X
NY8686443320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00853801Medicaid
NY02004891Medicaid
NY02702541Medicaid
NY01309879Medicaid
NY00555817Medicaid
NY00784721Medicaid
NY02353560Medicaid
NY01489830Medicaid