Organization
CENTRAL NEW YORK ADULT HOMES INC
Active
Other names
Evergreen Heights
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS CARLSON (EXECUTIVE DIRECTOR)
(315) 834-6142
Entity
Organization
Contact information
Practice address
8939 OAKLAND ST, WEEDSPORT, NY 13166-9417
(315) 834-6142
(315) 834-8960
Mailing address
8939 OAKLAND ST, WEEDSPORT, NY 13166-9417
(315) 834-6142
(315) 834-8960
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
050-E-010
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050-E-010
NEW YORK STATE DEPARTMENT OF HEALTH OPERATING CERTIFICATE
NY
01
—
AF0158B
FACILITY IDENTIFICATION NUMBER
NY
Enumeration date
09/15/2014
Last updated
09/15/2014
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