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General NPI Number Information
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NPI Number | 1295123198
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Entity Type | Organization
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Legal Business Name | HEATHWOOD ASSISTED LIVING AT WILLIAMSVILLE, INC.
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 815 HOPKINS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2320
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Country | US
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Telephone | 716-876-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 815 HOPKINS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2320
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Country | US
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Telephone | 716-876-0099
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Fax | 716-688-7266
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MRS. CARLA C SUERO
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Credential |
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Telephone | 71686880111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | NY
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