| NPI | 1215399043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE R CAPUZ Lpn 917-743-0542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: NY 276507-1) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |