National Provider Identifier
Park Ridge Nursing Home, Inc
Park Ridge Nursing Home, Inc is listed in the NPPES registry with a primary specialty of Home Health Agency in Rochester, NY and a listed phone number of (585) 368-6342.
Profile Overview
- NPI
- 1518015841
- Provider Type
- Organization
- Primary Specialty
- Home Health Agency
- Enumeration Date
- January 05, 2007
- Last Updated
- January 14, 2015
Practice Location
- 89 Genesee St
- Rochester, NY 14611-3201
Phone: (585) 368-6342
Specialties
- Home Health Agency (251E00000X)
Full Record
- NPI
- 1518015841
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Park Ridge Nursing Home, Inc
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 89 Genesee St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14611-3201
- Mailing Country
- US
- Mailing Phone
- (585) 368-6342
- Mailing Fax
- (585) 368-6395
- Practice Street Address
- 89 Genesee St
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14611-3201
- Practice Country
- US
- Practice Phone
- (585) 368-6342
- Practice Fax
- (585) 368-6395
- Enumeration Date
- January 05, 2007
- Last Updated
- January 14, 2015
- Authorized Official Last Name
- Bourne
- Authorized Official First Name
- Susan
- Authorized Official Title
- Vp Home Andcommunity Based Services
- Authorized Official Phone
- (585) 368-6454
- Organization Subpart
- Yes
- Parent Organization Name
- PARK RIDGE NURSING HOME, INC
- Parent Organization TIN
- <UNAVAIL>
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Home Health Agency (251E00000X)
- Other Identifiers
- 01185955 (NY), 109058C1 (NY, Preferred Care), P0101059PR (NY, Blue Choice)