Organization
HERITAGE VILLAGE REHAB & SKILLED NURSING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HAGLUND (CEO)
(716) 985-4612
Entity
Organization
Contact information
Practice address
4570 ROUTE 60, GERRY, NY 14740-0367
(716) 985-6700
Mailing address
4570 ROUTE 60, PO BOX 367, GERRY, NY 14740-0367
(716) 985-6811
(716) 985-6607
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0662300N
NY
343900000X
Non-emergency Medical Transport (VAN)
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000022001
BLUE CROSS BLUE SHIELD
—
01
—
0031396101
SENIOR CHOICE
—
05
—
00356327
—
NY
01
—
71Y200338
INDEPENDENT HEALTH EVERCA
—
Enumeration date
06/21/2005
Last updated
12/05/2025
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