| NPI | 1912275942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME VELEZ Lpn 347-401-4659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NY 299428-1) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |