| NPI | 1831696509 |
|---|---|
| Doing Business As | AUTUMN LAKE HEALTHCARE AT BRIDGEPARK |
| Entity Type | Organization |
| Authorized Contact | SAM STERN CFO 718-567-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-05-04 |