Provider Demographics
NPI:1740344605
Name:HART ASSOCIATES OF SPRINGVILLE, INC.
Entity type:Organization
Organization Name:HART ASSOCIATES OF SPRINGVILLE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:716-592-3172
Mailing Address - Street 1:168 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1016
Mailing Address - Country:US
Mailing Address - Phone:716-592-3172
Mailing Address - Fax:716-592-2249
Practice Address - Street 1:168 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1016
Practice Address - Country:US
Practice Address - Phone:716-592-3172
Practice Address - Fax:716-592-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1427302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
7UOtherINDEPENDENT HEALTH
000000216000OtherBLUE CROSS BLUE SHIELD
00011436903OtherUNIVERA
NY00475214Medicaid
7UOtherINDEPENDENT HEALTH