111 ENSMINGER ROAD OPERATING COMPANY LLC NPI 1467814632

NPI Information

111 ENSMINGER ROAD OPERATING COMPANY, LLC is an assisted living facility in Tonawanda, NY. The provider is 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. 111 ENSMINGER ROAD OPERATING COMPANY, LLC NPI is 1467814632. The provider is registered as an organization entity type.
The provider Is Doing Business As Elderwood Assisted Living At Tonawanda.

The provider's business location address is:

111 ENSMINGER RD
TONAWANDA, NY
ZIP 14150-719
Phone: (716) 871-1814

The provider's authorized official is Robert Heyert .
The authorized official title is Chief Financial Officer and has the following contact phone number (917) 690-5914.

The CLIA number assigned to this NPI record is 33D2197285 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2016 and was last updated on 3/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.