CENTRAL NEW YORK ADULT HOMES INC (NPI# 1760883383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760883383 |
| Entity Type | Organization |
| Organization Name | CENTRAL NEW YORK ADULT HOMES INC |
| Other Organization Name | EVERGREEN HEIGHTS |
| Practice Address |
8939 Oakland St Weedsport NY 13166-9417 |
| Practice Telephone | 3158346142 |
| Practice Fax Number | 3158348960 |
| Mailing Telephone | 3158346142 |
| Mailing Fax Number | 3158348960 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |
| Authorized Official Name | MR. THOMAS CARLSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3158346142 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 050-E-010 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NEW YORK STATE DEPARTMENT OF HEALTH OPERATING CERTIFICATE | 050-E-010 | 01 |
| NY | FACILITY IDENTIFICATION NUMBER | AF0158B | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen Heights | Doing Business As Name - Organization |
| Street Address |
8939 OAKLAND ST |
| City | WEEDSPORT |
| State | NY |
| Zip Code | 13166-9417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053673467 | Amanda Jo Moffitt | Licensed Practical Nurse | 3619 Chamberlin Rd., Weedsport, NY 13166 | 2012-06-12 |
| 1275717415 | Michelle Maginn | Pharmacist | 2783 Nys Route 31, Weedsport, NY 13166 | 2007-12-24 |
| 1952599920 | Patricia Ann Jones | Registered Nurse | 2802 Sharon St, Weedsport, NY 13166 | 2007-10-04 |
| 1215046123 | Kimberly H Fortin | Social Worker | 2693 East Brutus Street, Weedsport, NY 13166 | 2006-08-30 |
| 1538276712 | Kph Healthcare Services, Inc. | Pharmacy | 2783 Nys Rt 31, Weedsport, NY 13166 | 2006-08-24 |
| 1760499495 | Melanie J Raymond | Physical Therapist | 2685 Erie Dr, Raymond Physical Therapy Pllc, Weedsport, NY 13166 | 2006-08-02 |
| 1821310681 | Jeremy M Carr | Pharmacist | 2783 Nys Route 31, Weedsport, NY 13166 | 2010-02-22 |
| 1548816564 | Sierra Jaeger | Student in an Organized Health Care Education/Training Program | 3 Cedar Ln, Weedsport, NY 13166-3119 | 2019-08-15 |
| 1568634129 | April M Russell | Licensed Practical Nurse | 30 Woodside Ln, Weedsport, NY 13166-3147 | 2008-03-24 |
| 1548318967 | Christine Roth Gutelius | Dietitian, Registered | 2523 State Route 31, Weedsport, NY 13166-3202 | 2007-01-08 |
| Find all providers in zip 13166 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
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| 1457950966 | Kim One Family Type Homes for Adults | Assisted Living Facility | 361 California Ave, Uniondale, NY 11553-1857 | 2020-10-26 |
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| 1104442839 | Icc Management & Consulting, Inc | Assisted Living Facility | 11 S Union St, Cambridge, NY 12816-1008 | 2020-06-18 |
| 1366067738 | Fountainview At College Rd | Assisted Living Facility | 2000 Fountainview Dr, Monsey, NY 10952-2875 | 2020-06-11 |
| 1831734367 | The Sentinel of Port Jervis | Assisted Living Facility | 2247 Greenville Tpke, Port Jervis, NY 12771-3216 | 2019-11-07 |
| 1871135525 | Heather Hieghts of Pittsford | Assisted Living Facility | 160 W Jefferson Rd, Pittsford, NY 14534-1802 | 2019-10-15 |
| 1306499884 | Olean Manor Inc | Assisted Living Facility | 3260 N 7th St, Allegany, NY 14706-9532 | 2019-07-23 |
| 1053879791 | The Mohawk Homestead | Assisted Living Facility | 62 E. Main St., Mohawk, NY 13407 | 2019-03-12 |
| 1366907644 | Rebekah Rehab Assisted Living Program, Inc. | Assisted Living Facility | 1050 Havemeyer Ave, Bronx, NY 10462 | 2019-01-31 |
| 1699274290 | Rtacf LLC | Assisted Living Facility | 1 Buntline Dr, Stamford, NY 12167-1203 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.