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Organization

STEUBEN COUNTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRI DRAKE (ACCOUNTANT)
(607) 664-2438
Entity
Organization

Contact information

Practice address
3 PULTENEY SQ E, BATH, NY 14810-1510
(607) 664-2146
(607) 664-2197
Mailing address
3 PULTENEY SQ E, BATH, NY 14810-1510
(607) 664-2146
(607) 664-2197

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
252Y00000X
Early Intervention Provider Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00355880
NY
Enumeration date
03/22/2007
Last updated
06/14/2021
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