Organization
JEFFERSON REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL E. STERN (EXECUTIVE DIRECTOR)
(315) 788-2730
Entity
Organization
Contact information
Practice address
301 E GROVE ST, DEXTER, NY 13634-3147
(315) 639-6333
Mailing address
PO BOX 41, WATERTOWN, NY 13601-0041
(315) 788-2730
(315) 788-8557
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
7642450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01214662
—
NY
Enumeration date
05/16/2007
Last updated
08/22/2020
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