Provider Demographics
NPI:1538180286
Name:COUNTY OF GENESEE
Entity type:Organization
Organization Name:COUNTY OF GENESEE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING INTERIM ADMINIS
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANALE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:585-344-0584
Mailing Address - Street 1:278 BANK ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1616
Mailing Address - Country:US
Mailing Address - Phone:585-344-0584
Mailing Address - Fax:585-344-4685
Practice Address - Street 1:278 BANK ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1616
Practice Address - Country:US
Practice Address - Phone:585-344-0584
Practice Address - Fax:585-344-4685
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF GENESEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1801304N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356038Medicaid
NY335423Medicare ID - Type Unspecified