Provider Demographics
NPI:1003272626
Name:LATTA ROAD NURSING HOME EAST, LLC
Entity Type:Organization
Organization Name:LATTA ROAD NURSING HOME EAST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-244-0410
Mailing Address - Street 1:740 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2107
Mailing Address - Country:US
Mailing Address - Phone:585-244-0410
Mailing Address - Fax:585-244-1374
Practice Address - Street 1:2102 LATTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3728
Practice Address - Country:US
Practice Address - Phone:585-225-0920
Practice Address - Fax:585-225-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility