Provider Demographics
NPI:1811428816
Name:ARC OF OSWEGO COUNTY
Entity type:Organization
Organization Name:ARC OF OSWEGO COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-598-3108
Mailing Address - Street 1:7 MORRILL PL
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1530
Mailing Address - Country:US
Mailing Address - Phone:315-598-3108
Mailing Address - Fax:315-598-3306
Practice Address - Street 1:7 MORRILL PL
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1530
Practice Address - Country:US
Practice Address - Phone:315-598-3108
Practice Address - Fax:315-598-3306
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYSARC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable