Organization
COMPLETE SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN RONALD DAFOE (CONTROLLER)
(716) 285-8224
Entity
Organization
Contact information
Practice address
1302 MAIN ST, NIAGARA FALLS, NY 14301-1118
(716) 285-8224
(716) 285-8232
Mailing address
1302 MAIN ST, NIAGARA FALLS, NY 14301-1118
(716) 285-8224
(716) 285-8232
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03320725
—
NY
Enumeration date
06/20/2011
Last updated
04/07/2016
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