Provider Demographics
NPI:1386736098
Name:RECONSTRUCTION HOME AND HEALTH CARE CENTER, INC.
Entity type:Organization
Organization Name:RECONSTRUCTION HOME AND HEALTH CARE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORABITO
Authorized Official - Suffix:
Authorized Official - Credentials:NYS ADMINISTRATOR
Authorized Official - Phone:607-273-4166
Mailing Address - Street 1:318 S ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5406
Mailing Address - Country:US
Mailing Address - Phone:607-273-4166
Mailing Address - Fax:607-277-7004
Practice Address - Street 1:318 S ALBANY ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5406
Practice Address - Country:US
Practice Address - Phone:607-273-4166
Practice Address - Fax:607-277-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5401309N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00365857Medicaid
NY81055AMedicare UPIN
NY335017Medicare ID - Type UnspecifiedMEDICARE ID