Organization
CORTLAND COMMUNITY REENTRY PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT S. AUSTIN (BUSINESS MANAGER)
(607) 753-8241
Entity
Organization
Contact information
Practice address
149 MAIN ST, CORTLAND, NY 13045-2926
(607) 753-8241
(607) 753-0768
Mailing address
149 MAIN ST, CORTLAND, NY 13045-2926
(607) 753-8241
(607) 753-0768
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01715044
—
NY
Enumeration date
01/29/2007
Last updated
08/22/2020
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