Provider Demographics
NPI:1205343811
Name:CAYUGA COUNTY COMMUNITY HEALTH NETWORK, INC.
Entity type:Organization
Organization Name:CAYUGA COUNTY COMMUNITY HEALTH NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:SOULE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:315-252-4212
Mailing Address - Street 1:2119 W GENESEE STREET RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-9413
Mailing Address - Country:US
Mailing Address - Phone:315-252-4212
Mailing Address - Fax:315-252-3678
Practice Address - Street 1:2119 W GENESEE STREET RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021
Practice Address - Country:US
Practice Address - Phone:315-252-4212
Practice Address - Fax:315-252-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health