National Provider Identifier Database

UPSTATE CEREBRAL PALSY INC
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

UPSTATE CEREBRAL PALSY, INC
120 BROOKLEY ROAD
CRP #5
ROME, NY13341
Phone: 315-533-1166
Fax: 315-533-1165
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for UPSTATE CEREBRAL PALSY, INC

NPI Number 1871654863
Legal business name
LBN
UPSTATE CEREBRAL PALSY, INC
Authorized official GENO DECONDO - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/13/2006
Last updated 04/05/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 02683338
  • NY Medicaid: 02683338

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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