Organization
GROTON COMMUNITY HEALTH CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY EARLE (PRESIDENT CEO)
(607) 898-5876
Entity
Organization
Contact information
Practice address
120 SYKES STREET, GROTON, NY 13073
(607) 898-5876
(607) 898-3034
Mailing address
120 SYKES STREET, GROTON, NY 13073
(607) 898-5876
(607) 898-3034
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
80240432
NY
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
80240433
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02252913
—
NY
Enumeration date
05/23/2006
Last updated
08/22/2020
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