- Enrollment id
- O20150513001533
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1003208414
- Multiple npi flag
- N
- Ccn
- 335028
- Associate id
- 0042530172
- Organization name
- HIGHLAND VIEW CARE CENTER OPERATING CO., LLC
- Incorporation date
- 2013-03-19
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PRESTIGE NURSING CARE & REHAB CENTER
- Affiliation entity name
- CITADEL CARE CENTERS
- Affiliation entity id
- 146
- Address line 1
- 3400 CANNON PL
- City
- BRONX
- State
- NY
- Zip code
- 104634302