- Enrollment id
- O20050216000673
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1235138165
- Multiple npi flag
- N
- Ccn
- 335681
- Associate id
- 3274585302
- Organization name
- PALJR LLC
- Doing business as name
- EAST NECK NURSING AND REHABILITATION CENTER
- Incorporation date
- 2003-07-24
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- EAST NECK NURSING & REHABILITATION CENTER
- Affiliation entity name
- CASSENA CARE
- Affiliation entity id
- 119
- Address line 1
- 134 GREAT EAST NECK RD
- City
- WEST BABYLON
- State
- NY
- Zip code
- 117048027