Healthcare Provider Details

I. General information

NPI: 1780618645
Provider Name (Legal Business Name): MERCY HEALTH & REHABILITATION CENTER NH CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT ANTHONY ST
AUBURN NY
13021-4525
US

IV. Provider business mailing address

3 SAINT ANTHONY ST
AUBURN NY
13021-4525
US

V. Phone/Fax

Practice location:
  • Phone: 315-253-0351
  • Fax: 315-258-8010
Mailing address:
  • Phone: 315-253-0351
  • Fax: 315-258-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number0501308N
License Number StateNY

VIII. Authorized Official

Name: MS. DIANE DONNELLY
Title or Position: CFO
Credential: LNHA, CPA
Phone: 315-253-0351