=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396742755
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE HIGHLANDS LIVING CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2005
-----------------------------------------------------
Last Update Date | 03/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 HAHNEMANN TRL
-----------------------------------------------------
City | PITTSFORD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14534-2356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-383-1700
-----------------------------------------------------
Fax | 585-383-8339
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 HAHNEMANN TRL
-----------------------------------------------------
City | PITTSFORD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14534-2356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-383-1700
-----------------------------------------------------
Fax | 585-383-8339
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SAMUEL BUSARI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-332-3331
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------