NYSARC NIAGARA COUNTY CHAPTER
Intermediate Care Facility, Mentally Retarded
North Tonawanda, New York
Provider NPI: 1548334683
Organization Information:Organization Name: NYSARC NIAGARA COUNTY CHAPTER
Practice Location:
115 MEAD ST NORTH TONAWANDA, NY 14120 US
Tel: 716-297-6400 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:
115 MEAD ST NORTH TONAWANDA, NY 14120 US
Tel: 716-297-6400 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
02175708 | NY | 05 | |
OPERATING CERTIFICATE | 6116462 | NY | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin