- Enrollment id
- O20130828000224
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1376989376
- Multiple npi flag
- N
- Ccn
- 335231
- Associate id
- 7618110396
- Organization name
- EXCEL AT WOODBURY FOR REHABILITATION AND NURSING LLC
- Incorporation date
- 2012-06-20
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- EXCEL AT WOODBURY FOR REHABILITATION AND NURSING, LLC
- Affiliation entity name
- PARAGON HEALTHNET
- Affiliation entity id
- 395
- Address line 1
- 8533 JERICHO TPKE
- City
- WOODBURY
- State
- NY
- Zip code
- 117971804