Healthcare Provider Details

I. General information

NPI: 1346236981
Provider Name (Legal Business Name): ST ELIZABETH'S HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5539 BROADWAY ST
LANCASTER NY
14086-2223
US

IV. Provider business mailing address

5539 BROADWAY ST
LANCASTER NY
14086-2223
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-5150
  • Fax:
Mailing address:
  • Phone: 716-683-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number240E026
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number240E026
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number240E026
License Number StateNY

VIII. Authorized Official

Name: K DAVID CRONE
Title or Position: SR VP FINANCE/CFO
Credential:
Phone: 716-828-2024