# THER CENTERS AT ST. CAMILLUS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588094668
- **Authorized official:** OCTAVIA VENESE ROSS-HARDY (ILST)
- **Authorized official phone:** (315) 703-0685

## Contact information

- **Practice address:** 813 FAY RD, SYRACUSE, NY 13219-3009
- **Practice address phone:** (315) 703-0685
- **Practice address fax:** (315) 488-3804
- **Mailing address:** 813 FAY RD, SYRACUSE, NY 13219-3009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/26/2013
- **Last updated:** 04/30/2015