Provider Demographics
NPI:1982824702
Name:FAMILY SERVICE OF ROCHESTER
Entity Type:Organization
Organization Name:FAMILY SERVICE OF ROCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:CATTAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-388-2372
Mailing Address - Street 1:4646 NINE MILE POINT RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-1163
Mailing Address - Country:US
Mailing Address - Phone:585-388-2372
Mailing Address - Fax:585-388-2376
Practice Address - Street 1:399 COLVIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-1255
Practice Address - Country:US
Practice Address - Phone:585-436-9462
Practice Address - Fax:585-529-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY370S132310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01817936Medicaid