- Enrollment id
- O20071207000397
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1457358814
- Multiple npi flag
- N
- Ccn
- 335796
- Associate id
- 2769571181
- Organization name
- MEADOWBROOK CARE CENTER, INC.
- Incorporation date
- 1994-08-11
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- MEADOWBROOK CARE CENTER
- Address line 1
- 320W MERRICK RD
- City
- FREEPORT
- State
- NY
- Zip code
- 115203248