| NPI | 1013125467 |
|---|---|
| Doing Business As | UNDERWOOD MANOR LLHCSA |
| Entity Type | Organization |
| Authorized Contact | RONALD RAY JOHNSON Owner 716-595-8784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 0671A003) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |