Provider Demographics
NPI: | 1184996563 |
---|---|
Name: | CHAUTAUQUA COUNTY CASA - DSS |
Entity type: | Organization |
Organization Name: | CHAUTAUQUA COUNTY CASA - DSS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COMMISSIONER OF HUMAN SERVICES |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CHRISTINE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHUYLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | BSN, MHA |
Authorized Official - Phone: | 716-753-4590 |
Mailing Address - Street 1: | 7 N ERIE ST. HRC |
Mailing Address - Street 2: | |
Mailing Address - City: | MAYVILLE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 14757-1090 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 716-753-4447 |
Mailing Address - Fax: | 716-753-4692 |
Practice Address - Street 1: | 7 N ERIE ST FL 3 |
Practice Address - Street 2: | |
Practice Address - City: | MAYVILLE |
Practice Address - State: | NY |
Practice Address - Zip Code: | 14757-1095 |
Practice Address - Country: | US |
Practice Address - Phone: | 716-753-4447 |
Practice Address - Fax: | 716-753-4692 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-02-01 |
Last Update Date: | 2012-02-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 0622200R | 251K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251K00000X | Agencies | Public Health or Welfare |