Organization
MOSES LUDINGTON NURSING HOME COMPANY, INC
Active
Other names
Heritage Commons Residential Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA TIRADO (ADMINISTRATOR)
(518) 585-3800
Entity
Organization
Contact information
Practice address
1019 WICKER ST, TICONDEROGA, NY 12883-1039
(518) 585-3700
(518) 585-2576
Mailing address
1019 WICKER ST, TICONDEROGA, NY 12883-1039
(518) 585-3700
(518) 585-2576
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1527300
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400518001
BLUESHIELD NENY
NY
05
—
00311115
—
NY
01
—
012427
EMPIRE BLUE CROSS
NY
Enumeration date
08/25/2005
Last updated
12/07/2011
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