- Enrollment id
- O20110526000009
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1265724298
- Multiple npi flag
- N
- Ccn
- 335160
- Associate id
- 3971789041
- Organization name
- EAST ROCKAWAY CENTER LLC
- Doing business as name
- LYNBROOK RESTORATIVE THERAPY AND NURSING
- Incorporation date
- 2008-05-01
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LYNBROOK RESTORATIVE THERAPY AND NURSING
- Affiliation entity name
- PARAGON HEALTHNET
- Affiliation entity id
- 395
- Address line 1
- 243 ATLANTIC AVE
- City
- LYNBROOK
- State
- NY
- Zip code
- 115633552