Healthcare Provider Details

I. General information

NPI: 1306832613
Provider Name (Legal Business Name): GENESEE VALLEY PRESBYTERIAN NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 ALEXANDER ST
ROCHESTER NY
14607-2515
US

IV. Provider business mailing address

254 ALEXANDER ST
ROCHESTER NY
14607-2515
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-1991
  • Fax: 585-461-9833
Mailing address:
  • Phone: 585-461-1991
  • Fax: 585-461-9833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2701345N
License Number StateNY

VIII. Authorized Official

Name: MS. AMANDA D BROWN
Title or Position: EXECUTIVE VP/ADMINISTRATOR
Credential:
Phone: 585-461-1991