Organization
LAKE SHORE NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SCHREIER (SENIOR VP, CFO)
(716) 951-7147
Entity
Organization
Contact information
Practice address
845 ROUTES 5 AND 20, IRVING, NY 14081-9714
(716) 951-7060
Mailing address
12644 SENECA RD, IRVING, NY 14081-9714
(716) 951-7060
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00475163
—
NY
Enumeration date
03/19/2007
Last updated
08/22/2020
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