Organization
MEMORY GARDEN AT TANGLEWOOD MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI INGERSOLL (CHIEF OPERATING OFFICER)
(716) 483-2876
Entity
Organization
Contact information
Practice address
560 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2749
(716) 483-2876
Mailing address
560 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2749
(716) 483-2876
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
060F040
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03369835
—
NY
Enumeration date
11/07/2013
Last updated
11/07/2013
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