DAUGHTERS OF JACOB NURSING HOME CO
Skilled Nursing Facility
Bronx, New York
Provider NPI: 1194727156
Organization Information:Organization Name: DAUGHTERS OF JACOB NURSING HOME CO
Practice Location:
1160 TELLER AVE BRONX, NY 10456 US
Tel: 718-293-1500 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:
1160 TELLER AVE BRONX, NY 10456 US
Tel: 718-293-1500 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | NY | 7000342N |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
00310325 | NY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin