| NPI | 1609049337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER W. STOCKTON Chief Executive Officer 631-878-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-07 |