Provider Demographics
NPI:1144357963
Name:ABSOLUT CENTER FOR NURSING AND REHABILITATION AT SALAMANCA, LLC
Entity type:Organization
Organization Name:ABSOLUT CENTER FOR NURSING AND REHABILITATION AT SALAMANCA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-652-2820
Mailing Address - Street 1:300 GLEED AVE
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2980
Mailing Address - Country:US
Mailing Address - Phone:716-652-2820
Mailing Address - Fax:
Practice Address - Street 1:451 BROAD ST
Practice Address - Street 2:
Practice Address - City:SALAMANCA
Practice Address - State:NY
Practice Address - Zip Code:14779-1424
Practice Address - Country:US
Practice Address - Phone:716-945-1800
Practice Address - Fax:716-945-5867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0433303N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0001473902OtherUNIVERA/EXCELLUS
NY335534OtherMEDICARE PROVIDER
NY01660902Medicaid
NY7100368OtherUNITED HEALTHCARE
NY8UOtherINDEPENDENT HEALTH
NY000000340002OtherBLUE CROSS/BLUE SHIELD
NYBA1016OtherUPSTATE MEDICARE CARRIER
NY8UOtherINDEPENDENT HEALTH
NY335534OtherMEDICARE PROVIDER
NYRB2191Medicare PIN
NY7100368OtherUNITED HEALTHCARE