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Upstate Cerebral Palsy, Inc

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Utica, NY

NPI 1508926528 · NPPES record last updated Apr 5, 2023

Key facts

NPI
1508926528
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
01346607 (NY)
Legal business name
UPSTATE CEREBRAL PALSY, INC
Practice address
1247 Tilden Ave
Utica, NY 13501-4100
Phone
(315) 738-1734
Fax
(315) 733-3869
NPI assigned
Dec 11, 2006
Organization subpart
No

Authorized official

Name
Geno Decondo
Title
Executive Director
Phone
(315) 724-6907

Corporate family (same tax ID) 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Upstate Cerebral Palsy Inc (29 organizations share this tax ID)

Locations

1247 Tilden Ave
Utica, NY 13501
Phone (315) 738-1734

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 01346607 NY Yes

Addresses

Primary practice location

1247 Tilden Ave
Utica, NY 13501-4100

Mailing address

125 Business Park Dr
Utica, NY 13502-6305
Phone (315) 724-6907

Other identifiers

IdentifierTypeStateIssuer
01346607MedicaidNY

Other providers in Utica, NY

All providers in Utica, NY · Intellectual Disabilities Intermediate Care Facility in New York

Sources for this page

Verify at the official NPI Registry.