Organization
GRANDMA'S WISH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M CHALTAIN (OWNER/PROGRAM COORDINATOR)
(607) 345-6297
Entity
Organization
Contact information
Practice address
63 CLINTON ST, HOMER, NY 13077-1047
(607) 345-6297
Mailing address
63 CLINTON ST, HOMER, NY 13077-1047
(607) 345-6297
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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