- Enrollment id
- O20071019000032
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1538352182
- Multiple npi flag
- N
- Ccn
- 335581
- Associate id
- 4486740685
- Organization name
- BAY PARK CENTER FOR NURSING AND REHABILITATION, LLC
- Doing business as name
- PINNACLE MULTICARE NURSING AND REHABILITATION CENTER
- Incorporation date
- 2007-07-01
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PINNACLE MULTICARE NURSING AND REHABILITATION CENTER
- Affiliation entity name
- BENJAMIN LANDA
- Affiliation entity id
- 646
- Address line 1
- 801 CO OP CITY BLVD
- City
- BRONX
- State
- NY
- Zip code
- 104751603