- Enrollment id
- O20150625000240
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1083093306
- Multiple npi flag
- N
- Ccn
- 335829
- Associate id
- 0446561930
- Organization name
- L&A OPERATIONS LLC
- Incorporation date
- 2014-05-06
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ADIRA AT RIVERSIDE REHABILITATION AND NURSING
- Address line 1
- 120 ODELL AVE
- City
- YONKERS
- State
- NY
- Zip code
- 107011408