- Enrollment id
- O20160128001318
- Enrollment state
- ME
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1013396258
- Multiple npi flag
- N
- Ccn
- 205101
- Associate id
- 5395048169
- Organization name
- PINNACLE GROUP OF HUDSON VALLEY LLC
- Doing business as name
- PINNACLE HEALTH & REHAB
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PINNACLE HEALTH & REHAB CANTON
- Address line 1
- 26 PLEASANT ST
- City
- CANTON
- State
- ME
- Zip code
- 042213144