Provider Demographics
NPI:1588684906
Name:FINGER LAKES HOME CARE, INC.
Entity Type:Organization
Organization Name:FINGER LAKES HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-274-4225
Mailing Address - Street 1:756 PRE EMPTION RD.
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1336
Mailing Address - Country:US
Mailing Address - Phone:585-787-2233
Mailing Address - Fax:585-787-8740
Practice Address - Street 1:756 PRE EMPTION RD.
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1336
Practice Address - Country:US
Practice Address - Phone:315-789-9821
Practice Address - Fax:315-789-4034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 374U00000X
NY3402901L374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01823587Medicaid