Provider Demographics
NPI:1053630731
Name:PRCD, INC.
Entity Type:Organization
Organization Name:PRCD, INC.
Other - Org Name:DAISY MARQUIS JONES WOMEN'S COMMUNITY RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT HEALTH CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-723-7185
Mailing Address - Street 1:2650 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4209
Mailing Address - Country:US
Mailing Address - Phone:585-723-7717
Mailing Address - Fax:585-723-7358
Practice Address - Street 1:2650 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4209
Practice Address - Country:US
Practice Address - Phone:585-723-7717
Practice Address - Fax:585-723-7358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRCD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-20
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility