Provider Demographics
NPI:1508196676
Name:OPPORTUNITIES FOR OTSEGO, INC
Entity type:Organization
Organization Name:OPPORTUNITIES FOR OTSEGO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-433-8000
Mailing Address - Street 1:3 WEST BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2223
Mailing Address - Country:US
Mailing Address - Phone:607-433-8038
Mailing Address - Fax:607-433-8029
Practice Address - Street 1:3 W BROADWAY
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2223
Practice Address - Country:US
Practice Address - Phone:607-433-8038
Practice Address - Fax:607-433-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054960251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health