- Enrollment id
- O20080325000301
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1134390321
- Multiple npi flag
- N
- Ccn
- 335328
- Associate id
- 4486730918
- Organization name
- PALM GARDENS CARE CENTER LLC
- Doing business as name
- PALM GARDENS CENTER FOR NURSING AND REHABILITATION
- Incorporation date
- 2007-12-06
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PALM GARDENS CENTER FOR NURSING AND REHABILITATION
- Affiliation entity name
- SHIMON LEFKOWITZ
- Affiliation entity id
- 795
- Address line 1
- 615 AVENUE C
- City
- BROOKLYN
- State
- NY
- Zip code
- 112184101