Provider Demographics
NPI:1629393079
Name:WILLCARE
Entity Type:Organization
Organization Name:WILLCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:GERTRUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-757-2780
Mailing Address - Street 1:4315 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELBA
Mailing Address - State:NY
Mailing Address - Zip Code:14058-9763
Mailing Address - Country:US
Mailing Address - Phone:585-757-2780
Mailing Address - Fax:
Practice Address - Street 1:4315 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELBA
Practice Address - State:NY
Practice Address - Zip Code:14058-9763
Practice Address - Country:US
Practice Address - Phone:585-757-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1173161251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health