Organization
JENNIE B. RICHMOND CHAFFEE NURSING HOME COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER JOHN SORICELLI (ADMINISTRATOR)
(716) 592-2871
Entity
Organization
Contact information
Practice address
222 E MAIN ST, SPRINGVILLE, NY 14141-1443
(716) 592-2871
(716) 592-8103
Mailing address
222 E MAIN ST, SPRINGVILLE, NY 14141-1443
(716) 592-2871
(716) 592-8103
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1427000N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011457901
UNIVERA HEALTHCARE
NY
05
—
00475278
—
NY
01
—
140
BC/BS OF WNY
NY
01
—
R4
INDEPENDENT HEALTH
NY
Enumeration date
08/18/2005
Last updated
04/04/2012
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