Organization
SULLIVAN PARK HEALTHCARE CENTER, INC
Active
Other names
The Waters of Endicott
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SMITH (TREASURER)
(716) 805-1474
Entity
Organization
Contact information
Practice address
301 NANTUCKET DR, ENDICOTT, NY 13760-2735
(607) 754-2705
(607) 754-2610
Mailing address
300 GLEED AVE, THE PARK ASSOCIATES, INC., EAST AURORA, NY 14052-2980
(716) 652-2820
(716) 655-2320
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0302301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00949817
—
NY
Enumeration date
06/04/2006
Last updated
08/01/2008
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