Provider Demographics
NPI:1891246278
Name:WILLCARE
Entity Type:Organization
Organization Name:WILLCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN FIELD SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LEGTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:716-499-0312
Mailing Address - Street 1:220 FLUVANNA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-2052
Mailing Address - Country:US
Mailing Address - Phone:716-487-1131
Mailing Address - Fax:
Practice Address - Street 1:220 FLUVANNA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2052
Practice Address - Country:US
Practice Address - Phone:716-487-1131
Practice Address - Fax:716-487-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7033501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health