Healthcare Provider Details

I. General information

NPI: 1386736098
Provider Name (Legal Business Name): RECONSTRUCTION HOME AND HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 S ALBANY ST
ITHACA NY
14850-5406
US

IV. Provider business mailing address

318 S ALBANY ST
ITHACA NY
14850-5406
US

V. Phone/Fax

Practice location:
  • Phone: 607-273-4166
  • Fax: 607-277-7004
Mailing address:
  • Phone: 607-273-4166
  • Fax: 607-277-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5401309N
License Number StateNY

VIII. Authorized Official

Name: MS. VICTORIA L. MORABITO
Title or Position: CEO
Credential: NYS ADMINISTRATOR
Phone: 607-273-4166