Healthcare Provider Details

I. General information

NPI: 1306901913
Provider Name (Legal Business Name): ROCHESTER REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ELMWOOD AVE
ROCHESTER NY
14620-3042
US

IV. Provider business mailing address

1000 ELMWOOD AVE
ROCHESTER NY
14620-3042
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-2520
  • Fax: 585-295-8029
Mailing address:
  • Phone: 585-271-2520
  • Fax: 585-295-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number2701223R
License Number StateNY

VIII. Authorized Official

Name: CYNTHIA KELLY
Title or Position: INTERIM CEO
Credential: LCSW
Phone: 585-271-2520