Organization
PROACTION OF STEUBEN AND YATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN PIERSON (MEDICAID ENROLLMENT MANAGER)
(607) 776-2125
Entity
Organization
Contact information
Practice address
117 E STEUBEN ST, BATH, NY 14810-1636
(607) 776-2125
(607) 776-2723
Mailing address
117 E STEUBEN ST, BATH, NY 14810-1636
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01054113
—
NY
Enumeration date
04/18/2007
Last updated
09/04/2007
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