- Enrollment id
- O20050531000161
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1558397323
- Multiple npi flag
- N
- Ccn
- 335756
- Associate id
- 1052353125
- Organization name
- SMITHTOWN HEALTH CARE MANAGEMENT
- Doing business as name
- SMITHTOWN CENTER FOR REHABILITATION AND NURSING CARE
- Incorporation date
- 2005-06-07
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SMITHTOWN CENTER FOR REHABILITATION & NURSING CARE
- Affiliation entity name
- CENTER MANAGEMENT GROUP
- Affiliation entity id
- 619
- Address line 1
- 391 N COUNTRY RD
- City
- SMITHTOWN
- State
- NY
- Zip code
- 117872069