Healthcare Provider Details
I. General information
NPI: 1841284775
Provider Name (Legal Business Name): COUNTY OF CATTARAUGUS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2005
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2245 W STATE ST
OLEAN NY
14760-1921
US
IV. Provider business mailing address
2245 W STATE ST
OLEAN NY
14760-1921
US
V. Phone/Fax
- Phone: 716-373-1910
- Fax: 716-373-1805
- Phone: 716-373-1910
- Fax: 716-373-1805
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 0401303N |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 0401303N |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | OPERATING CERTIFICATE NO. |
VIII. Authorized Official
Name:
CAROL
V
GUGINO
Title or Position: CONTROLLER
Credential:
Phone: 716-373-1910