Provider Demographics
NPI:1629702527
Name:VS SERVICER AT BEACON, LLC
Entity type:Organization
Organization Name:VS SERVICER AT BEACON, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBENBLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-826-2010
Mailing Address - Street 1:455 CAYUGA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1300
Mailing Address - Country:US
Mailing Address - Phone:716-829-1957
Mailing Address - Fax:716-634-1394
Practice Address - Street 1:10 HASTINGS DR
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2055
Practice Address - Country:US
Practice Address - Phone:845-440-1600
Practice Address - Fax:845-440-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility