Healthcare Provider Details

I. General information

NPI: 1346390317
Provider Name (Legal Business Name): GENEVA NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 198 NORTH ST
GENEVA NY
14456-1651
US

IV. Provider business mailing address

196 - 198 NORTH ST
GENEVA NY
14456-1651
US

V. Phone/Fax

Practice location:
  • Phone: 315-787-4150
  • Fax: 315-787-4794
Mailing address:
  • Phone: 315-787-4150
  • Fax: 315-787-4794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA E JOHNSON
Title or Position: TREASURER AND CFO
Credential:
Phone: 315-787-4030