Provider Demographics
NPI:1063549889
Name:ABSOLUT CENTER FOR NURSING AND REHABILITATION AT DUNKIRK, LLC
Entity type:Organization
Organization Name:ABSOLUT CENTER FOR NURSING AND REHABILITATION AT DUNKIRK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-652-2820
Mailing Address - Street 1:300 GLEED AVE
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2980
Mailing Address - Country:US
Mailing Address - Phone:716-652-2820
Mailing Address - Fax:
Practice Address - Street 1:447 LAKE SHORE DR W
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-1479
Practice Address - Country:US
Practice Address - Phone:716-366-6710
Practice Address - Fax:716-366-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0601303N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000308002OtherBLUE CROSS/BLUE SHIELD
NY00011474602OtherUNIVERA/EXCELLUS
NY01058759Medicaid
NY4UOtherINDEPENDENT HEALTH
NY7100362OtherUNITED HEALTHCARE
NY7100288OtherEVERCARE
NY000000308002OtherBLUE CROSS/BLUE SHIELD
NY4UOtherINDEPENDENT HEALTH