Organization
ST. REGIS NURSING HOME & HEALTH RELATED FACILITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WHEELER D MAYNARD JR. N.H.A. (ADMINISTRATOR)
(315) 769-2494
Entity
Organization
Contact information
Practice address
89 GROVE ST, MASSENA, NY 13662-2615
(315) 769-2494
(315) 769-3604
Mailing address
89 GROVE ST, MASSENA, NY 13662-2615
(315) 769-2494
(315) 769-3604
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4402303N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00308190
—
NY
Enumeration date
10/28/2005
Last updated
10/13/2011
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