Provider Demographics
NPI:1700253499
Name:CATHOLIC CHARITIES OF THE DIOXECE OF ROCHESTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOXECE OF ROCHESTER
Other - Org Name:CAHTOLIC CHARITIES OF THE FINGER LAKES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:315-789-2686
Mailing Address - Street 1:94 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1830
Mailing Address - Country:US
Mailing Address - Phone:315-789-2686
Mailing Address - Fax:315-789-5785
Practice Address - Street 1:94 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1830
Practice Address - Country:US
Practice Address - Phone:315-789-2686
Practice Address - Fax:315-789-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty