Provider Demographics
NPI:1336593920
Name:YATES COUNTY CHAPTER, NYSARC INC
Entity Type:Organization
Organization Name:YATES COUNTY CHAPTER, NYSARC INC
Other - Org Name:ARC OF YATES CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-536-7447
Mailing Address - Street 1:235 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1051
Mailing Address - Country:US
Mailing Address - Phone:315-536-7447
Mailing Address - Fax:315-536-3281
Practice Address - Street 1:235 NORTH AVE
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1051
Practice Address - Country:US
Practice Address - Phone:315-536-7447
Practice Address - Fax:315-536-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities