- Enrollment id
- O20091204000000
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1538194709
- Multiple npi flag
- N
- Ccn
- 335100
- Associate id
- 0941382485
- Organization name
- ISABELLA GERIATRIC CENTER, INC.
- Incorporation date
- 1991-07-01
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- ISABELLA GERIATRIC CENTER INC
- Address line 1
- 515 AUDUBON AVE
- City
- NEW YORK
- State
- NY
- Zip code
- 100403403