- Enrollment id
- O20170404001766
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053767848
- Multiple npi flag
- N
- Ccn
- 335201
- Associate id
- 0042596181
- Organization name
- ABRAHAM OPERATIONS ASSOCIATES LLC
- Doing business as name
- BETH ABRAHAM CENTER FOR REHABILITATION AND NURSING
- Incorporation date
- 2015-12-11
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BETH ABRAHAM CENTER FOR REHABILITATION AND NURSING
- Affiliation entity name
- CENTERS HEALTH CARE
- Affiliation entity id
- 127
- Address line 1
- 612 ALLERTON AVE
- City
- BRONX
- State
- NY
- Zip code
- 104677404