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27 Franklin St Springville NY 14141-1314 | |
(716) 592-9301 | |
(716) 592-9376 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 27 Franklin St, Springville, New York |
Authorized Official Name and Position | Bruce Nisbet (PRESIDENT./CEO) |
Authorized Official Contact | 7166622040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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227 Thorn Ave Box 631 Orchard Park NY 14127-2600 Ph: (716) 662-2040 | 27 Franklin St Springville NY 14141-1314 Ph: (716) 592-9301 |
NPI Number | 1598939480 |
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Provider Enumeration Date | 04/22/2008 |
Last Update Date | 07/19/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598939480 | NPI | - | NPPES |
000000812000 | Other | NY | BCBS |
00660577 | Medicaid | NY | |
8401220 | Other | NY | IHA |
040727000154 | Other | NY | MEDICAID MANAGED CARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 091110871 (New York) | Primary |