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General NPI Number Information
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NPI Number | 1831119122
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Entity Type | Organization
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Legal Business Name | GREENWOOD RESIDENCES, INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 660 MINERAL SPRINGS RD
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City | WEST SENECA
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State | NY
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Zip | 14224-1018
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Country | US
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Telephone | 716-827-4060
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Fax | 716-827-4063
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Provider Business Mailing Address
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Address Line | 2700 N FOREST RD
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City | GETZVILLE
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State | NY
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Zip | 14068-1527
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Country | US
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Telephone | 716-639-3311
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Fax | 716-639-3309
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. PATRICIA CIOCCA-BRACISZEWSKI
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Credential |
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Telephone | 716-827-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 8879430
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License Number State | NY
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