Provider Demographics
NPI:1609133628
Name:ALLEGANY COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity type:Organization
Organization Name:ALLEGANY COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-268-9303
Mailing Address - Street 1:7 COURT ST
Mailing Address - Street 2:OFFICE BUILDING ROOM 127
Mailing Address - City:BELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:14813-1044
Mailing Address - Country:US
Mailing Address - Phone:585-268-9304
Mailing Address - Fax:585-268-9479
Practice Address - Street 1:7 COURT ST
Practice Address - Street 2:OFFICE BUILDING ROOM 127
Practice Address - City:BELMONT
Practice Address - State:NY
Practice Address - Zip Code:14813-1044
Practice Address - Country:US
Practice Address - Phone:585-268-9304
Practice Address - Fax:585-268-9479
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGANY COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00317024Medicaid