Organization
ST. CAMILLUS RESIDENTIAL HEALTH CARE FACILITY
Active
Other names
St. Camillus TBI Waiver Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ZINGARO (CFO)
(315) 703-0646
Entity
Organization
Contact information
Practice address
813 FAY RD, SYRACUSE, NY 13219-3009
(315) 488-2951
(315) 488-7734
Mailing address
813 FAY RD, SYRACUSE, NY 13219-3009
(315) 488-2951
(315) 488-7734
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
TBI00076
NY
251S00000X
Community/Behavioral Health Agency
TBI00076
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01585359
—
NY
Enumeration date
02/08/2007
Last updated
09/19/2016
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