Healthcare Provider Details

I. General information

NPI: 1831184621
Provider Name (Legal Business Name): HARDING NURSING HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2005
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 TOWER ST
WATERVILLE NY
13480-1194
US

IV. Provider business mailing address

220 TOWER ST
WATERVILLE NY
13480-1128
US

V. Phone/Fax

Practice location:
  • Phone: 315-841-4156
  • Fax: 315-841-8856
Mailing address:
  • Phone: 315-841-4156
  • Fax: 315-841-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3226301N
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT S. HARDING
Title or Position: COMPTROLLER
Credential:
Phone: 315-841-4156