Provider Demographics
NPI:1821392713
Name:KAPSON SENIOR QUARTERS CORP.
Entity Type:Organization
Organization Name:KAPSON SENIOR QUARTERS CORP.
Other - Org Name:PENFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-779-7683
Mailing Address - Street 1:2006 FIVE MILE LINE RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1419
Mailing Address - Country:US
Mailing Address - Phone:585-381-0282
Mailing Address - Fax:
Practice Address - Street 1:2006 FIVE MILE LINE RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1419
Practice Address - Country:US
Practice Address - Phone:585-381-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAPSON SENIOR QUARTERS CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility