| Ithaca Alpha House Center, Inc. | |
|
334 W State St Ithaca NY 14850-5432 | |
| (607) 273-5500 | |
| (607) 273-1277 |
| Full Name | Ithaca Alpha House Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 334 W State St, Ithaca, New York |
| Authorized Official Name and Position | Susan M Oaks (CHIEF FINANCIAL OFFICERE) |
| Authorized Official Contact | 6073875535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ithaca Alpha House Center, Inc. 38 East Main Street Po Box 724 Trumansburg NY 14886 Ph: (607) 387-5535 | Ithaca Alpha House Center, Inc. 334 W State St Ithaca NY 14850-5432 Ph: (607) 273-5500 |
| NPI Number | 1548262363 |
|---|---|
| Provider Enumeration Date | 08/11/2005 |
| Last Update Date | 10/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548262363 | NPI | - | NPPES |
| 01292828 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 070510837 (New York) | Primary |
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