Provider Demographics
NPI:1003803271
Name:SENECA HEALTH CARE CENTER LLC
Entity Type:Organization
Organization Name:SENECA HEALTH CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:POLANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-828-0500
Mailing Address - Street 1:2987 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2648
Mailing Address - Country:US
Mailing Address - Phone:716-828-0500
Mailing Address - Fax:716-828-1377
Practice Address - Street 1:2987 SENECA ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2648
Practice Address - Country:US
Practice Address - Phone:716-828-0500
Practice Address - Fax:716-828-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1474301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00475365Medicaid
NY00475365Medicaid