| NPI | 1295210904 |
|---|---|
| Doing Business As | EAST LAKE ARBOR |
| Entity Type | Organization |
| Authorized Contact | GERALD PHILLIP STOLL Mbr 917-836-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2022-01-19 |