Organization
MOHAWK VALLEY NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH P REID (CEO)
(315) 895-4050
Entity
Organization
Contact information
Practice address
99 6TH AVE, ILION, NY 13357-1527
(315) 895-4050
(315) 895-7197
Mailing address
99 6TH AVE, ILION, NY 13357-1527
(315) 895-4050
(315) 895-7197
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473941
—
NY
05
—
01167977
—
NY
Enumeration date
11/07/2006
Last updated
08/29/2008
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