Organization
PENN YAN MANOR NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA FISH (FISCAL MANAGER)
(315) 536-2311
Entity
Organization
Contact information
Practice address
655 LIBERTY ST, PENN YAN, NY 14527-1086
(315) 536-2311
(315) 536-1033
Mailing address
655 LIBERTY ST, PENN YAN, NY 14527-1086
(315) 536-2311
(315) 924-2906
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
6120300N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355711
—
NY
01
—
1162
PFI
NY
01
—
6120300N
OPERATING CERTIFICATE
NY
Enumeration date
09/07/2005
Last updated
06/12/2025
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