Organization
ODD FELLOW AND REBEKAH REHABILITATION AND HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARLENE SUE DICARLO (DIRECTOR OF FINANCE)
(716) 434-6324
Entity
Organization
Contact information
Practice address
104 OLD NIAGARA RD, LOCKPORT, NY 14094-1500
(716) 434-6324
(716) 434-4020
Mailing address
104 OLD NIAGARA RD, LOCKPORT, NY 14094-1500
(716) 434-6324
(716) 434-4020
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3101305N
NY
385H00000X
Respite Care
3101305N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00356372
—
NY
Enumeration date
03/12/2007
Last updated
08/10/2015
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