Organization
VILLAGE PARK HEALTHCARE CENTER, INC.
Active
Other names
The Waters of Gasport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SMITH (TREASURER)
(716) 805-1474
Entity
Organization
Contact information
Practice address
4540 LINCOLN DR, GASPORT, NY 14067-9212
(716) 772-2631
(716) 772-2054
Mailing address
300 GLEED AVE, THE PARK ASSOCIATES, INC., EAST AURORA, NY 14052-2980
(716) 652-2820
(716) 655-2320
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3158301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000254000
BLUE CROSS & BLUE SHIELD
NY
01
—
00011428901
UNIVERA
NY
05
—
01514718
—
NY
01
—
6V
INDEPENDENT HEALTH
NY
Enumeration date
05/31/2006
Last updated
08/01/2008
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