- Enrollment id
- O20080125000124
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1265429856
- Multiple npi flag
- N
- Ccn
- 335286
- Associate id
- 6901988203
- Organization name
- CARILLON NURSING AND REHABILITATION CENTER, LLC
- Doing business as name
- CARILLON NURSING AND REHABILITATION CENTER
- Incorporation date
- 1999-09-10
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CARILLON NURSING AND REHABILITATION CENTER
- Affiliation entity name
- CASSENA CARE
- Affiliation entity id
- 119
- Address line 1
- 830 PARK AVE
- City
- HUNTINGTON
- State
- NY
- Zip code
- 117434543