Organization
MENTAL HEALTH SERVICES OF ERIE COUNTY SECV
Active
Other names
Spectrum Human Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE NISBET (CEO/PRESIDENT)
(716) 662-2040
Entity
Organization
Contact information
Practice address
2040 SENECA ST, BUFFALO, NY 14210-2324
(716) 828-0560
(716) 828-1522
Mailing address
227 THORN AVE, BOX 631, ORCHARD PARK, NY 14127-2600
(716) 662-2040
(716) 662-0019
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
080110870
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000812000
BCBS
NY
01
—
00011227702
UNIVERA
NY
05
—
00660577
—
NY
01
—
040727000154
MEDICAID MANAGED CARE
NY
01
—
8401220
IHA
NY
Enumeration date
04/22/2008
Last updated
07/18/2015
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