Provider Demographics
NPI:1851683890
Name:ARISE CHILD AND FAMILY SERVICES
Entity Type:Organization
Organization Name:ARISE CHILD AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINNENBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-671-2956
Mailing Address - Street 1:113 SCHUYLER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1652
Mailing Address - Country:US
Mailing Address - Phone:315-887-5156
Mailing Address - Fax:
Practice Address - Street 1:113 SCHUYLER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1652
Practice Address - Country:US
Practice Address - Phone:315-887-5156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064048251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health