Provider Demographics
NPI:1922069822
Name:SOUTHERN TIER HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:SOUTHERN TIER HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SALEVSKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:585-593-3240
Mailing Address - Street 1:198 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-1153
Mailing Address - Country:US
Mailing Address - Phone:585-593-3240
Mailing Address - Fax:585-593-3336
Practice Address - Street 1:198 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1153
Practice Address - Country:US
Practice Address - Phone:585-593-3240
Practice Address - Fax:585-593-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0891L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00737417Medicaid
NY01363620Medicaid