| 220 Front Street Llc | |
|
220 Front St Vestal NY 13850-1514 | |
| (607) 222-9913 | |
| (607) 821-4855 |
| Full Name | 220 Front Street Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 220 Front St, Vestal, New York |
| Authorized Official Name and Position | Mario Nunes (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6072229913 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 220 Front Street Llc 220 Front St Vestal NY 13850-1514 Ph: (607) 222-9913 | 220 Front Street Llc 220 Front St Vestal NY 13850-1514 Ph: (607) 222-9913 |
| NPI Number | 1366175937 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/01/2022 |
| Certification Date | 07/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366175937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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