Organization
ST JOSEPHS MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
K DAVID CRONE (SR VP FINANCE/CFO)
(716) 828-2024
Entity
Organization
Contact information
Practice address
2211 W STATE ST, OLEAN, NY 14760-1921
(716) 372-7810
Mailing address
2211 W STATE ST, OLEAN, NY 14760-1921
(716) 372-7810
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0401301N
NY
314000000X
Skilled Nursing Facility
Primary
0401301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030592301
UNIVERA
NY
05
—
00475136
—
NY
01
—
11
IHA
NY
01
—
271
HEALTHNOW
NY
Enumeration date
09/20/2005
Last updated
09/11/2025
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