Provider Demographics
NPI:1811046113
Name:HOME CARE FOR CORTLAND COUNTY, INC.
Entity Type:Organization
Organization Name:HOME CARE FOR CORTLAND COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:607-753-9326
Mailing Address - Street 1:111 PORT WATSON ST
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-3157
Mailing Address - Country:US
Mailing Address - Phone:607-753-9326
Mailing Address - Fax:607-756-8458
Practice Address - Street 1:111 PORT WATSON ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-3157
Practice Address - Country:US
Practice Address - Phone:607-753-9326
Practice Address - Fax:607-756-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0180L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00896442Medicaid
NY01204466Medicaid