Healthcare Provider Details

I. General information

NPI: 1861487498
Provider Name (Legal Business Name): WNY CATHOLIC LONG TERM CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 POWERS RD
ORCHARD PARK NY
14127-4841
US

IV. Provider business mailing address

6400 POWERS RD
ORCHARD PARK NY
14127-4841
US

V. Phone/Fax

Practice location:
  • Phone: 716-667-0001
  • Fax: 716-667-0028
Mailing address:
  • Phone: 716-667-0001
  • Fax: 716-667-0028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1435302N
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1435302N
License Number StateNY

VIII. Authorized Official

Name: THOMAS GLEASON
Title or Position: SENIOR VICE PRESIDENT HOME AND COMM
Credential:
Phone: 716-706-2439