- Enrollment id
- O20120127000010
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467720334
- Multiple npi flag
- N
- Ccn
- 335558
- Associate id
- 4284801523
- Organization name
- KFG OPERATING TWO, LLC
- Doing business as name
- BENSONHURST CENTER FOR REHABILITATION & HEALTHCARE
- Incorporation date
- 2010-09-22
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BENSONHURST CENTER FOR REHABILITATION & HEALTHCARE
- Affiliation entity name
- CENTER MANAGEMENT GROUP
- Affiliation entity id
- 619
- Address line 1
- 1740 84TH ST
- City
- BROOKLYN
- State
- NY
- Zip code
- 112142825