MEDICARE: EPISCOPAL RESIDENTIAL HEALTH CARE FACILITY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013909761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPISCOPAL RESIDENTIAL HEALTH CARE FACILITY INC

Provider Business Mailing Address
First Line	:	24 RHODE ISLAND ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-2142
Country	:	US
Telephone Number	:	716-884-6500
Fax Number	:	716-614-0840

Provider Business Practice Location Address
First Line	:	24 RHODE ISLAND ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-2142
Country	:	US
Telephone Number	:	716-884-6500
Fax Number	:	716-614-0840

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT/CFO
Name	:	MR. JAMES J JULIAND
Credential	:
Telephone Number	:	716-883-7917

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/21/2022

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