Provider Demographics
NPI:1154513422
Name:URBAN LEAGUE OF ROCHESTER, N.Y., INC.
Entity type:Organization
Organization Name:URBAN LEAGUE OF ROCHESTER, N.Y., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-325-6530
Mailing Address - Street 1:265 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-1857
Mailing Address - Country:US
Mailing Address - Phone:585-325-6530
Mailing Address - Fax:585-325-4864
Practice Address - Street 1:265 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-1857
Practice Address - Country:US
Practice Address - Phone:585-325-6530
Practice Address - Fax:585-325-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management