Healthcare Provider Details

I. General information

NPI: 1902933799
Provider Name (Legal Business Name): SENECA HILL MANOR ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MANOR DR
OSWEGO NY
13126-6495
US

IV. Provider business mailing address

20 MANOR DR
OSWEGO NY
13126-6495
US

V. Phone/Fax

Practice location:
  • Phone: 315-349-5300
  • Fax: 315-349-5365
Mailing address:
  • Phone: 315-349-5300
  • Fax: 315-349-5365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number3702312N
License Number StateNY

VIII. Authorized Official

Name: JASON SANTIAGO
Title or Position: ADMINISTRATOR & CEO
Credential:
Phone: 315-349-5300