Provider Demographics
NPI:1235344714
Name:ALLSTATE HOMECARE OF BUFFALO, INC
Entity Type:Organization
Organization Name:ALLSTATE HOMECARE OF BUFFALO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-565-3626
Mailing Address - Street 1:6490 MAIN ST
Mailing Address - Street 2:PO BOX 1561
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231-5853
Mailing Address - Country:US
Mailing Address - Phone:716-565-3626
Mailing Address - Fax:716-565-3631
Practice Address - Street 1:6490 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5853
Practice Address - Country:US
Practice Address - Phone:716-565-3626
Practice Address - Fax:716-565-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0240L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00679525Medicaid
NY00806708Medicaid