Organization
LOYOLA RECOVERY FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE BASHER (PRESIDENT)
(585) 203-1005
Entity
Organization
Contact information
Practice address
76 VETERANS AVE, 6TH FLOOR, BATH, NY 14810-0810
(607) 664-5800
(607) 664-5801
Mailing address
1159 PITTSFORD VICTOR RD, PITTSFORD, NY 14534-3808
(585) 203-1005
(585) 203-1013
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00689721
—
NY
Enumeration date
11/21/2006
Last updated
07/28/2015
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