- Enrollment id
- O20161202000432
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1356893986
- Multiple npi flag
- N
- Ccn
- 335775
- Associate id
- 1456631753
- Organization name
- SBNH ACQUISITION LLC
- Doing business as name
- BRONX GARDENS REHABILITATION AND NURSING CENTER
- Incorporation date
- 2015-03-12
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BRONX GARDENS REHABILITATION AND NURSING CENTER
- Affiliation entity name
- CITADEL CARE CENTERS
- Affiliation entity id
- 146
- Address line 1
- 2175 QUARRY RD
- City
- BRONX
- State
- NY
- Zip code
- 104571663