UPSTATE CEREBRAL PALSY INC NPI 1649426214

NPI Information

NPI: 1649426214
Provider Name: UPSTATE CEREBRAL PALSY, INC

Former Legal Business Name: UNITED CEREBRAL PALSY

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
138 W GERMAN ST
HERKIMER, NY
ZIP 13350
Phone: (315) 724-6907
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UPSTATE CEREBRAL PALSY, INC is a community based residential treatment facility mental illness in Herkimer, NY. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. UPSTATE CEREBRAL PALSY, INC NPI is 1649426214. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is United Cerebral Palsy.

The provider's business location address is:

138 W GERMAN ST
HERKIMER, NY
ZIP 13350-101
Phone: (315) 724-6907
Fax: (315) 733-0791

The provider's authorized official is Geno Decondo .
The authorized official title is Executive Director and has the following contact phone number (315) 724-6907.

The enumeration date for this NPI number is 8/14/2008 and was last updated on 4/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		6282433	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01303855	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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