Organization
LORETTO INDEPENDENT LIVING SERVICES INC.
Active
Other names
PACE CNY
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY ABULENCIA (VICE PRESIDENT, PACE OPERATIONS)
(315) 415-4449
Entity
Organization
Contact information
Practice address
100 MALTA LN, NORTH SYRACUSE, NY 13212-2375
(315) 452-5800
Mailing address
100 MALTA LN, NORTH SYRACUSE, NY 13212-2375
(315) 452-5800
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01519162
—
NY
Enumeration date
04/22/2013
Last updated
04/22/2013
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