Organization
BAKER HALL
Active
Other names
OLV Human Services
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL B PARZYCH (CFO/COO)
(716) 828-9751
Entity
Organization
Contact information
Practice address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 828-9700
(716) 828-9450
Mailing address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 828-9751
(716) 828-9450
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
7577120A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011307201
UNIVERA HEALTHCARE
—
01
—
0005120761
BLUE CROSS OF WNY
NY
05
—
01101413
—
NY
01
—
6307336
INDEPENDENT HEALTH
NY
Enumeration date
04/11/2007
Last updated
06/12/2024
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