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General NPI Number Information
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NPI Number | 1255338117
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Entity Type | Organization
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Legal Business Name | THE CHURCH HOME OF THE PROTESTANT EPISCOPAL CHURCH IN THE CITY OF ROCH
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 505 MOUNT HOPE AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-2251
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Country | US
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Telephone | 585-546-8400
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Fax | 585-325-6553
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Provider Business Mailing Address
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Address Line | 505 MOUNT HOPE AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-2251
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Country | US
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Telephone | 585-546-8400
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Fax | 585-325-6553
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Authorized Official
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Title or Position | EXECUTIVE VP/CFO
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Name | MS. LISA J MARCELLO
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Credential | CPA
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Telephone | 585-546-8400
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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 | 2701339N
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License Number State | NY
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