Provider Demographics
NPI:1801093265
Name:COHOES MULTI-SERVICE SENIOR CITIZENS CENTER, INC.
Entity type:Organization
Organization Name:COHOES MULTI-SERVICE SENIOR CITIZENS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-235-2420
Mailing Address - Street 1:10 CAYUGA PLAZA
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047
Mailing Address - Country:US
Mailing Address - Phone:518-235-2420
Mailing Address - Fax:518-235-1624
Practice Address - Street 1:10 CAYUGA PLAZA
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047
Practice Address - Country:US
Practice Address - Phone:518-235-2420
Practice Address - Fax:518-235-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347B00000X
261QA0600X, 347B00000X, 332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No347B00000XTransportation ServicesBus
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02754947Medicaid