Healthcare Provider Details

I. General information

NPI: 1003818618
Provider Name (Legal Business Name): HEATHWOOD HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HOPKINS RD
WILLIAMSVILLE NY
14221-2320
US

IV. Provider business mailing address

815 HOPKINS RD
WILLIAMSVILLE NY
14221-2320
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-0111
  • Fax: 716-688-7266
Mailing address:
  • Phone: 716-688-0111
  • Fax: 716-688-7266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1451302N
License Number StateNY

VIII. Authorized Official

Name: MRS. DARLENE GALE
Title or Position: DIRECTOR OF ACCOUNTS RECEIVABLE
Credential:
Phone: 716-633-0021