- Enrollment id
- O20070725000456
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1144424805
- Multiple npi flag
- N
- Ccn
- 335820
- Associate id
- 4183725898
- Organization name
- JACKSON HEIGHTS CARE CENTER, LLC
- Doing business as name
- REGAL HEIGHTS REHABILITATION AND HEALTH CARE CENTER
- Incorporation date
- 2000-12-27
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- REGAL HEIGHTS REHABILITATION AND HEALTH CARE CENTER
- Address line 1
- 70-05 35TH AVENUE
- City
- JACKSON HEIGHTS
- State
- NY
- Zip code
- 113723970