RONALD R. JOHNSON
Adult Care Home
Hinsdale, New York
Provider NPI: 1013125467
Organization Information:Organization Name: RONALD R. JOHNSON
Practice Location:
4460 UNION HILL RD HINSDALE, NY 14743 US
Tel: 716-557-2322 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
4460 UNION HILL RD HINSDALE, NY 14743 US
Tel: 716-557-2322 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | NY | 0671A003 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
02731313 | NY | 05 | |
DOH LICENSE | 0671A003 | NY | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin