Provider Demographics
NPI:1053684001
Name:UCRN LLC
Entity Type:Organization
Organization Name:UCRN LLC
Other - Org Name:FOCUS REHABILITATION AND NURSING AT UTICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUPNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-732-0100
Mailing Address - Street 1:1445 KEMBLE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-4441
Mailing Address - Country:US
Mailing Address - Phone:315-732-0100
Mailing Address - Fax:315-732-2342
Practice Address - Street 1:1445 KEMBLE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4441
Practice Address - Country:US
Practice Address - Phone:315-732-0100
Practice Address - Fax:315-732-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3202313N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01640904Medicaid
NY335794Medicare Oscar/Certification