Organization
UPSTATE PCA INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON GREEN HHA (SUPORVISOR/PROVIDER)
(315) 542-4209
Entity
Organization
Contact information
Practice address
1216 GRAY AVE, UTICA, NY 13502-3959
(315) 542-4209
Mailing address
1216 GRAY AVE APT 2F, UTICA, NY 13502-3967
(315) 542-4209
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
07/25/2024
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