Provider Demographics
NPI:1003818618
Name:HEATHWOOD HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:HEATHWOOD HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-633-0021
Mailing Address - Street 1:815 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2320
Mailing Address - Country:US
Mailing Address - Phone:716-688-0111
Mailing Address - Fax:716-688-7266
Practice Address - Street 1:815 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2320
Practice Address - Country:US
Practice Address - Phone:716-688-0111
Practice Address - Fax:716-688-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1451302N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00475269Medicaid
NY00475269Medicaid