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Organization

WOODSIDE MANOR NURSING HOME, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT W HURLBUT (OWNER/PRESIDENT)
(585) 244-0410
Entity
Organization

Contact information

Practice address
2425 CLINTON AVE S, ROCHESTER, NY 14618-2646
(585) 461-0370
(585) 461-5897
Mailing address
740 EAST AVE, ROCHESTER, NY 14607-2107
(585) 244-0410
(585) 244-1208

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2750303
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00355615
NY
Enumeration date
06/16/2005
Last updated
10/14/2015
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