Organization
NORTH PARK NURSING HOME, INC.
Active
Other names
Edna Tina Wilson Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA TEUGEMAN (ADMINISTRATOR , NHA)
(585) 368-6105
Entity
Organization
Contact information
Practice address
700 ISLAND COTTAGE RD, ROCHESTER, NY 14612-2312
(585) 368-6100
(585) 368-6110
Mailing address
700 ISLAND COTTAGE RD, ROCHESTER, NY 14612-2312
(585) 368-6100
(585) 368-6110
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01447869
—
NY
01
—
0150059ET
BLUE SHIELD BLUE CHOICE
NY
01
—
NH620
PREFERRED CARE
NY
Enumeration date
01/04/2007
Last updated
04/10/2017
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