Provider Demographics
NPI:1962399394
Name:SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK, INC.
Entity type:Organization
Organization Name:SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:YEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-701-6879
Mailing Address - Street 1:135 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 KENNEDY ST STE 101
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2065
Practice Address - Country:US
Practice Address - Phone:716-375-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02587231Medicaid