Organization
JEFFERSON COUNTY COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY D. TINGLEY LMSW (DIRECTOR)
(315) 785-3283
Entity
Organization
Contact information
Practice address
175 ARSENAL ST, WATERTOWN, NY 13601-2528
(315) 785-3283
(315) 785-5182
Mailing address
175 ARSENAL ST, WATERTOWN, NY 13601-2528
(315) 785-3283
(315) 785-5182
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01430666
—
NY
Enumeration date
01/30/2007
Last updated
08/22/2020
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