Organization
RONALD R. JOHNSON
Active
Other names
Underwood Manor LLHCSA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD RAY JOHNSON (OWNER)
(716) 595-8784
Entity
Organization
Contact information
Practice address
4460 UNION HILL RD, HINSDALE, NY 14743-9715
(716) 557-2322
Mailing address
2063 ROUTE 83, FORESTVILLE, NY 14062-9639
(716) 965-2644
(716) 965-4163
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
0671A003
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02731313
—
NY
01
—
0671A003
DOH LICENSE
NY
Enumeration date
05/18/2007
Last updated
08/22/2020
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