Organization
UPSTATE PCA INSTITUTE
Active
Other names
Upstate pca institute
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON GREEN HHA,PCA (MD)
(315) 864-0416
Entity
Organization
Contact information
Practice address
1216 GRAY AVE, UTICA, NY 13502-3959
(315) 542-4209
Mailing address
1216 GRAY AVE APT 2F, UTICA, NY 13502-3967
(315) 864-0416
(270) 203-0587
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/08/2023
Last updated
12/14/2024
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