- Enrollment id
- O20100121000281
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467433664
- Multiple npi flag
- N
- Ccn
- 335416
- Associate id
- 5395887855
- Organization name
- DRY HARBOR HRF INC
- Incorporation date
- 1967-06-08
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- DRY HARBOR NURSING HOME
- Address line 1
- 6135 DRY HARBOR RD
- City
- MIDDLE VILLAGE
- State
- NY
- Zip code
- 113791528