Provider Demographics
NPI:1710041397
Name:THE RESOURCE CENTER
Entity Type:Organization
Organization Name:THE RESOURCE CENTER
Other - Org Name:CHAUTAUQUA COUNTY CHAPTER, NYSARC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CESANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-661-1412
Mailing Address - Street 1:880 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-3824
Mailing Address - Country:US
Mailing Address - Phone:716-661-1400
Mailing Address - Fax:
Practice Address - Street 1:896 E 2ND ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-3826
Practice Address - Country:US
Practice Address - Phone:716-661-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0602201R261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00639487Medicaid