Basic Information
| Provider Information | |||||||||
| NPI: | 1811088719 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE NEIGHBORHOOD CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 293 GENESEE ST | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 135013804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152722600 | ||||||||
| FaxNumber: | 3157338169 | ||||||||
| Practice Location | |||||||||
| Address1: | 628 MARY ST | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 135012419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152722700 | ||||||||
| FaxNumber: | 3157322229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 03/13/2015 | ||||||||
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| AuthorizedOfficialLastName: | SOROKA | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3152722600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 7998120A | NY | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251B00000X | N | Agencies | Case Management | 101YM0800X | 7998120A | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 01415058 | 05 | NY | MEDICAID | 02997419 | 05 | NY | MEDICAID | 01556481 | 05 | NY | MEDICAID |