Healthcare Provider Details

I. General information

NPI: 1124014774
Provider Name (Legal Business Name): ST FRANCIS GERIATRIC & HEALTHCARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 BENWOOD AVE
BUFFALO NY
14214-1761
US

IV. Provider business mailing address

34 BENWOOD AVE
BUFFALO NY
14214-1761
US

V. Phone/Fax

Practice location:
  • Phone: 716-862-2501
  • Fax:
Mailing address:
  • Phone: 716-862-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1401334N
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1401334N
License Number StateNY

VIII. Authorized Official

Name: JAMES A DUNLOP
Title or Position: SR VP FINANCE/CFO
Credential:
Phone: 716-862-2431