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General NPI Number Information
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NPI Number | 1275523482
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE OF WESTERN NEW YORK, INC.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 115 E MAIN ST
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City | ALLEGANY
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State | NY
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Zip | 14706-1318
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Country | US
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Telephone | 716-372-2106
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Fax | 716-372-1148
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Provider Business Mailing Address
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Address Line | 115 E MAIN ST
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City | ALLEGANY
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State | NY
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Zip | 14706-1318
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Country | US
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Telephone | 716-372-2106
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Fax | 716-372-1148
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. MELISSA SULLIVAN
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Credential |
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Telephone | 716-372-2106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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