- Enrollment id
- O20150522000413
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1396753224
- Multiple npi flag
- N
- Ccn
- 335700
- Associate id
- 2567375421
- Organization name
- LONG ISLAND JEWISH MEDICAL CENTER
- Doing business as name
- NORTH SHORE-LIJ ORZAC CENTER FOR REHABILITATION
- Incorporation date
- 1949-10-20
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- NORTH SHORE - LIJ ORZAC CENTER FOR REHABILITATION
- Address line 1
- 900 FRANKLIN AVE
- City
- VALLEY STREAM
- State
- NY
- Zip code
- 115802145