Organization
TIOGA HEALTHCARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY LATSHAW (ASSISTANT ADMINISTRATOR)
(607) 565-6228
Entity
Organization
Contact information
Practice address
44 BALL ST, WAVERLY, NY 14892-1200
(607) 565-6216
Mailing address
44 BALL ST, WAVERLY, NY 14892-1200
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
720-S-001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01439225
—
NY
Enumeration date
07/07/2005
Last updated
08/22/2020
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