Organization
CENTRAL NEW YORK ADULT HOMES INC
Active
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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