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General NPI Number Information
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NPI Number | 1164815916
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE AT WILLIAMSVILLE LLC
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 147 REIST ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5321
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Country | US
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Telephone | 716-633-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 147 REIST STREET
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-633-5400
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JASON TEITELBAUM
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Credential |
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Telephone | 716-633-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 142130010
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License Number State | NY
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