Organization
NYSARC, INC. BROOME-TIOGA COUNTY CHAPTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO THORN (EXECUTIVE DIRECTOR)
(607) 723-8361
Entity
Organization
Contact information
Practice address
125 CUTLER POND RD, BINGHAMTON, NY 13905-1564
(607) 723-8361
(607) 231-5310
Mailing address
125 CUTLER POND RD, BINGHAMTON, NY 13905-1564
(607) 723-8361
(607) 231-5310
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6066120
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066440
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066441
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066442
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066443
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066444
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066450
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066454
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066461
NY
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
6066462
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02246082
—
NY
Enumeration date
10/14/2005
Last updated
08/22/2020
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