Organization
CEREBRAL PALSY & HANDICAPPED CHILDRENS ASSOC. OF CHEMUNG CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PETERS (EXECUTIVE DIRECTOR)
(607) 734-7107
Entity
Organization
Contact information
Practice address
398 OLD ITHACA RD, ICF, HORSEHEADS, NY 14845-7202
(607) 734-3592
Mailing address
PO BOX 1554, 1118 CHARLES ST, ELMIRA, NY 14902-1554
(607) 734-7107
(607) 734-7334
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
6515440
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00806428
—
NY
Enumeration date
02/07/2007
Last updated
08/22/2020
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