| NPI | 1609149335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL D MARTIN RN 631-475-8819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NY 420290-1) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: NY 420290-1) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |