- Enrollment id
- O20100312000005
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1407844194
- Multiple npi flag
- N
- Ccn
- 335656
- Associate id
- 6305971656
- Organization name
- HAYM SALOMON HOME FOR THE AGED, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- HAYM SOLOMON HOME FOR THE AGED
- Address line 1
- 2340 CROPSEY AVE
- City
- BROOKLYN
- State
- NY
- Zip code
- 112145706