Healthcare Provider Details

I. General information

NPI: 1144643750
Provider Name (Legal Business Name): TOWN OF HAMBURG ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 PLEASANT AVE
HAMBURG NY
14075-4717
US

IV. Provider business mailing address

353 PLEASANT AVE
HAMBURG NY
14075-4717
US

V. Phone/Fax

Practice location:
  • Phone: 716-646-0255
  • Fax: 716-646-0240
Mailing address:
  • Phone: 716-646-0255
  • Fax: 716-646-0240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN WALTERS
Title or Position: SUPERVISOR
Credential:
Phone: 716-649-6111