Organization
WELLSVILLE MANOR LLC
Active
Other names
Wellsville Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN GEWIRTZ (MANAGER, FISCAL OVERSIGHT)
(914) 588-8379
Entity
Organization
Contact information
Practice address
4192A BOLIVAR RD, WELLSVILLE, NY 14895-9325
(585) 593-4400
(585) 593-4418
Mailing address
4192A BOLIVAR RD, WELLSVILLE, NY 14895-9325
(585) 593-4400
(585) 593-4418
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00752167
—
NY
Enumeration date
11/09/2005
Last updated
09/09/2015
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