Organization
FAIRPORT BAPTIST HOME ADHC
Active
Other names
Lifetimes Adult Day Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERARD J WOYTASH (VICE PRESIDENT OF FINANCE)
(585) 388-2303
Entity
Organization
Contact information
Practice address
14001 S PLYMOUTH AVE, ROCHESTER, NY 14611
(585) 388-2303
Mailing address
4646 NINE MILE POINT RD, FAIRPORT, NY 14450-1163
(585) 388-2303
(585) 377-2620
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01703382
—
NY
Enumeration date
11/19/2009
Last updated
11/19/2009
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