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Organization

37 NORTH CHEMUNG STREET OPERATING COMPANY, LLC

Active
Other names
Elderwood at Waverly
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY RUBIN (CO- CHIEF EXECUTIVE OFFICER)
(716) 817-5075
Entity
Organization

Contact information

Practice address
37 N CHEMUNG ST, WAVERLY, NY 14892-1211
(607) 565-2861
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 633-3900

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03006604
NY
Enumeration date
01/07/2016
Last updated
01/19/2023
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