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Organization
PARK RIDGE NURSING HOME, INC
Active
Organization
PARK RIDGE NURSING HOME, INC
Active
Parent organization
PARK RIDGE NURSING HOME, INC
Other names
Park Ridge at Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK RIDGE NURSING HOME, INC
Authorized official
SUSAN BOURNE (VP HOME ANDCOMMUNITY BASED SERVICES)
(585) 368-6454
Entity
Organization
Contact information
Practice address
89 GENESEE ST, ROCHESTER, NY 14611-3201
(585) 368-6342
(585) 368-6395
Mailing address
89 GENESEE ST, ROCHESTER, NY 14611-3201
(585) 368-6342
(585) 368-6395
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01185955
—
NY
01
—
109058C1
PREFERRED CARE
NY
01
—
P0101059PR
BLUE CHOICE
NY
Enumeration date
01/05/2007
Last updated
01/14/2015
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