Healthcare Provider Details

I. General information

NPI: 1639426679
Provider Name (Legal Business Name): CATTARAUGUS REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1439 BUFFALO ST
OLEAN NY
14760-1140
US

IV. Provider business mailing address

1439 BUFFALO ST
OLEAN NY
14760-1140
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-4747
  • Fax: 716-375-4795
Mailing address:
  • Phone: 716-375-4747
  • Fax: 716-375-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1426L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1426L001
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1426L001
License Number StateNY

VIII. Authorized Official

Name: MRS. MARI L HOWARD
Title or Position: COO
Credential:
Phone: 716-375-4747