National Provider Identifier

Ibero American Action Lueage, Inc.

Ibero American Action Lueage, Inc. is listed in the NPPES registry with a primary specialty of Case Management Agency in Rochester, NY and a listed phone number of (585) 256-8900.

NPI 1164061628Rochester, NYCase Management Agency

Profile Overview

NPI
1164061628
Provider Type
Organization
Primary Specialty
Case Management Agency
Enumeration Date
January 02, 2020
Last Updated
January 02, 2020

Practice Location

  • 817 East Main Street
  • Same
  • Rochester, NY 14605-5144

Phone: (585) 256-8900

Specialties

  • Case Management Agency (251B00000X)
  • Developmentally Disabled Services Day Training Agency (251C00000X)
  • Respite Care (385H00000X)
Full Record
NPI
1164061628
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Ibero American Action Lueage, Inc.
Mailing Street Address
817 East Main Street
Mailing Address Line 2
Same
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14605-5144
Mailing Country
US
Mailing Phone
(585) 256-8900
Mailing Fax
(585) 544-8608
Practice Street Address
817 East Main Street
Practice Address Line 2
Same
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14605-5144
Practice Country
US
Practice Phone
(585) 256-8900
Practice Fax
(585) 544-8608
Enumeration Date
January 02, 2020
Last Updated
January 02, 2020
Authorized Official Last Name
Marin
Authorized Official First Name
Grisell
Authorized Official Title
Hcbs Director
Authorized Official Phone
(585) 256-8900
Organization Subpart
No
Authorized Official Name Prefix Text
MS.
Authorized Official Credential Text
BS, CASAC- T
Certification Date
January 02, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Case Management Agency (251B00000X), Developmentally Disabled Services Day Training Agency (251C00000X), Respite Care (385H00000X)