Healthcare Provider Details

I. General information

NPI: 1053630731
Provider Name (Legal Business Name): PRCD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGEWAY AVE
ROCHESTER NY
14626-4209
US

IV. Provider business mailing address

2650 RIDGEWAY AVE
ROCHESTER NY
14626-4209
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7717
  • Fax: 585-723-7358
Mailing address:
  • Phone: 585-723-7717
  • Fax: 585-723-7358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS STEWART
Title or Position: PRESIDENT HEALTH CARE SERVICES
Credential:
Phone: 585-723-7185