Provider Demographics
NPI:1710126990
Name:ROCHESTER REHABILITATION CENTER
Entity Type:Organization
Organization Name:ROCHESTER REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PENROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:585-271-2520
Mailing Address - Street 1:1000 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3042
Mailing Address - Country:US
Mailing Address - Phone:585-271-2520
Mailing Address - Fax:585-271-1198
Practice Address - Street 1:1000 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3042
Practice Address - Country:US
Practice Address - Phone:585-271-2520
Practice Address - Fax:585-271-1198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072535261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)