| NPI | 1013441328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA97 MARIA FICI Lpn 631-806-9048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |