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TANGLEWOOD MANOR, INC
NPI 1932302882
Assisted Living Facility in Jamestown, NY

Active since June 07, 2007CLIA 33D2176080 · Waiver
560 FAIRMOUNT AVENUE, JAMESTOWN, NY 14701(716) 483-2876(716) 483-2832 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 3, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Tanglewood Manor, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TANGLEWOOD MANOR, INC (NPI 1932302882) is a healthcare organization registered as an assisted living facility in Jamestown, New York and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Terri L Ingersoll, Administrator, as its authorized official.

NPPES Registry Identity

NPI1932302882
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameTANGLEWOOD MANOR, INC
Location Address560 FAIRMOUNT AVENUEJamestown, NY 14701-2749
Mailing Address560 Fairmount AvenueJamestown, NY 14701-2749 · (716) 483-2876 · Fax (716) 483-2832
Phone(716) 483-2876
Fax(716) 483-2832
Organization SubpartNo
Authorized OfficialTerri L IngersollAdministrator · (716) 483-2876
Enumeration DateJune 7, 2007
Last NPPES UpdateDecember 3, 20252 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
✔ NPI 1932302882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in NY · 03A1922
Definition
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.
Also ListedClinic/Center · Adult Day CareTaxonomy 261QA0600X
Also ListedCustodial Care Facility · Adult Care HomeTaxonomy 311ZA0620X
560 FAIRMOUNT AVENUE, Jamestown, NY 14701
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Other Identifiers 1

Medicaid01879583NY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2176080

Tanglewood Manor · Jamestown, NY
Active · expires Mar 26, 2027
CLIA Number33D2176080
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 9, 2019
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Jason Ford
Laboratory Phone(716) 483-2876
Laboratory LocationTanglewood Manor560 Fairmount Ave - We, Jamestown, NY 14701
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tanglewood Manor, Inc's NPI number?

The NPI number for Tanglewood Manor, Inc is 1932302882. It was assigned to this organization in the NPPES registry on June 7, 2007.

Where is Tanglewood Manor, Inc located?

Tanglewood Manor, Inc is located at 560 Fairmount Avenue, Jamestown, NY 14701. The listed phone number is (716) 483-2876.

What is Tanglewood Manor, Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Tanglewood Manor, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2176080) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tanglewood Manor, Inc was last updated on December 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.