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Organization

UPSTATE CEREBRAL PALSY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENO DECONDO (EXECUTIVE DIRECTOR)
(315) 724-6907
Entity
Organization

Contact information

Practice address
90 GEIGER RD, ROME, NY 13441-4319
(315) 724-6907
(315) 733-0791
Mailing address
125 BUSINESS PARK DR, UTICA, NY 13502-6305
(315) 724-6907

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
02850686
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02850686
NY
Enumeration date
04/20/2007
Last updated
04/05/2023
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