CNYDDSO (NPI# 1356700488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356700488 |
| Entity Type | Organization |
| Organization Name | CNYDDSO |
| Other Organization Name | OPWDD |
| Practice Address |
1315 Schuyler St Rome NY 13440-2825 |
| Mailing Address |
1315 Schuyler St Rome NY 13440 |
| Practice Telephone | 3157944469 |
| Mailing Telephone | 3157944469 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Authorized Official Name | KENT A MYERS (SENIOR OT) |
| Authorized Official Telephone | 3153396536 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 007106-1 | NY | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| opwdd | Other Name - Individual/Organization |
| Street Address |
1315 SCHUYLER ST |
| City | ROME |
| State | NY |
| Zip Code | 13440-2825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409966 | Jamie Marcinkowski | Nurse Practitioner | 1617 N James Street, Suite 100, Rome, NY 13440 | 2020-08-28 |
| 1205452810 | Nichole Elizabeth Pollard | Optometrist | 1320 Floyd Ave, Suite 1, Rome, NY 13440 | 2020-06-19 |
| 1235750662 | Nicole Schrader | Social Worker | 7214 Bunal Blvd, Rome, NY 13440 | 2020-04-27 |
| 1457908212 | Darlene A. Sherman | Technician | 101 Glen Road S., Rome, NY 13440 | 2019-08-26 |
| 1841846847 | Delores A Smith | Technician | 7374 Davis Road, Rome, NY 13440 | 2019-08-15 |
| 1609342807 | Kent A Myers | Occupational Therapist | 200 West Dominic St, Rome, NY 13440 | 2018-10-16 |
| 1013376870 | Bonnie Flansburg | Physical Therapy Assistant | 101 W Liberty Street, Rome, NY 13440 | 2016-02-22 |
| 1760888689 | Ashley Elizabeth Bloomquist | Pharmacist | 808 West Chestnut Street, Rome, NY 13440 | 2014-11-05 |
| 1902231483 | Stephanie Ostalkiewicz | Licensed Practical Nurse | 701 Camp Street, Rome, NY 13440 | 2013-09-04 |
| 1992142251 | Tammy S. Guiliano | Registered Nurse | 401 Turin Street, The New York State School for The Deaf, Rome, NY 13440 | 2013-05-28 |
| Find all providers in zip 13440 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043541915 | Clover House, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 496 N Avery Rd Nw, Rome, GA 30165-7970 | 2010-01-16 |
| 1376756361 | Julie M, Smith | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 802 Augusta Rd, Rome, ME 04963-3137 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548722549 | The Alternative Living Group, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 New Karner Road, Suite 3, Albany, NY 12205 | 2019-04-01 |
| 1366914772 | Michelle Thomas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2713 Colonial Dr, New Windsor, NY 12553-4925 | 2018-12-24 |
| 1730659327 | Nathalie Lawrence Ot P C | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 566 Macon Pl, Uniondale, NY 11553-2829 | 2018-11-27 |
| 1598249831 | Annie Hwang Pt P.C. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 26 Teneyck Ave, Valley Stream, NY 11580-4016 | 2018-09-22 |
| 1801396841 | Tlc Kids Therapy, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3270 Mark Alan Dr, Wantagh, NY 11793-1841 | 2018-02-16 |
| 1760929715 | Sheltering Arms Children and Family Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2749 University Ave, Apt 3, Bronx, NY 10468-3302 | 2017-01-30 |
| 1417499385 | J. Gudis Speech and Language | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 E 31st St Apt 5d, New York, NY 10016-6828 | 2016-11-09 |
| 1134592470 | Beacon Group | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 54 Henry Ave, Babylon, NY 11702-1327 | 2015-11-09 |
| 1558733568 | Task Recovery Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2716 Avenue Y, Brooklyn, NY 11235-2008 | 2015-10-29 |
| 1699144675 | Delores James | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24412 135th Ave, Rosedale, NY 11422-1604 | 2015-09-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.