Organization
BERKSHIRE FARM CENTER AND SERVICES FOR YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN COX (CHIEF FINANCIAL OFFICER)
(518) 781-4567
Entity
Organization
Contact information
Practice address
1059 SILBEY TOWER BUILDING, MEDICAID SERVICE COORDINATION PROGRAM, ROCHESTER, NY 14604
(585) 454-1620
(585) 454-6814
Mailing address
1059 SILBEY TOWER BUILDING, MEDICAID SERVICE COORDINATION PROGRAM, ROCHESTER, NY 14604
(585) 454-1620
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0501010545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02388058
—
NY
Enumeration date
02/06/2007
Last updated
08/22/2020
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