Healthcare Provider Details

I. General information

NPI: 1851439194
Provider Name (Legal Business Name): TIOGA NURSING FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 N CHEMUNG ST
WAVERLY NY
14892-1211
US

IV. Provider business mailing address

37 N CHEMUNG ST
WAVERLY NY
14892-1211
US

V. Phone/Fax

Practice location:
  • Phone: 607-565-2861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ROSE MCCORT
Title or Position: DIRECTOR OF RESIDENT ACCOUNTS
Credential:
Phone: 607-565-6332