- Enrollment id
- O20190318002659
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1477024966
- Multiple npi flag
- N
- Ccn
- 335211
- Associate id
- 1759621352
- Organization name
- GLENGARIFF OPERATING LLC
- Doing business as name
- GLENGARIFF REHABILITATION AND HEALTHCARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GLENGARIFF REHABILITATION AND HEALTHCARE CENTER
- Affiliation entity name
- CARERITE CENTERS
- Affiliation entity id
- 110
- Address line 1
- 141 DOSORIS LN
- City
- GLEN COVE
- State
- NY
- Zip code
- 115421225