- Enrollment id
- O20071205000108
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1366424350
- Multiple npi flag
- N
- Ccn
- 335799
- Associate id
- 6800985409
- Organization name
- UNION PLAZA NURSING HOME INC
- Doing business as name
- UNION PLAZA CARE CENTER
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- UNION PLAZA CARE CENTER
- Address line 1
- 3323 UNION ST
- City
- FLUSHING
- State
- NY
- Zip code
- 113543050