| NPI | 1962683045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES SERWAH OBENG Lpn 518-207-1501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: NY 268485-1) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2007-11-17 |