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Organization
SELF-DIRECT INC.
Active
Organization
SELF-DIRECT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA A PALUMBO (PRESIDENT)
(315) 635-5374
Entity
Organization
Contact information
Practice address
7758 MAPLE ROAD, BALDWINSVILLE, NY 13027
(315) 635-5374
(315) 635-5375
Mailing address
7758 MAPLE ROAD, BALDWINSVILLE, NY 13027
(315) 635-5374
(315) 635-5375
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1606L001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02413674
—
NY
05
—
03160689
—
NY
Enumeration date
05/24/2012
Last updated
10/14/2020
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