Provider Demographics
NPI:1952798688
Name:JCTOD OUTREACH, INC
Entity type:Organization
Organization Name:JCTOD OUTREACH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:CRPA
Authorized Official - Phone:315-269-8580
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13503-0160
Mailing Address - Country:US
Mailing Address - Phone:315-734-9608
Mailing Address - Fax:315-266-1223
Practice Address - Street 1:26 JOHNSON PARK
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13503-0160
Practice Address - Country:US
Practice Address - Phone:315-734-9608
Practice Address - Fax:315-266-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251V00000XAgenciesVoluntary or Charitable
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle