| NPI | 1235642042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKE WEINTRAUB Manager 718-812-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |