| NPI | 1972832590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESTON JASON JOHN Program Coordinator 718-735-7151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NY 9108L001) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |