SUFFOLK CENTER RECEIVER LLC
Custodial Care Facility
Pathchogue, New York
Provider NPI: 1396807244
Organization Information:Organization Name: SUFFOLK CENTER RECEIVER LLC
Practice Location:
25 SCHOENFELD BLVD PATHCHOGUE, NY 11772 US
Tel: 631-289-7700 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
25 SCHOENFELD BLVD PATHCHOGUE, NY 11772 US
Tel: 631-289-7700 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | ||
N | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | NY | 5123300N |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | NY | 5123300N |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
00309733 | NY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin