Organization
GERRY HOMES INC
Active
Other names
Heritage Green Outpatient Therapy Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BOSWELL (VICE PRESIDENT OF FINANCE)
(716) 338-9766
Entity
Organization
Contact information
Practice address
3023 ROUTE 430, GREENHURST, NY 14742
(716) 483-5000
Mailing address
PO BOX 365, GERRY, NY 14740
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011450401
UNIVERA PROVIDER ID
NY
01
—
Y4
INDEPENDENT HEALTH
NY
Enumeration date
10/02/2006
Last updated
07/13/2022
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