- Enrollment id
- O20040419000186
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1568535284
- Multiple npi flag
- N
- Ccn
- 335771
- Associate id
- 6507851607
- Organization name
- THROGS NECK OPERATING CO LLC
- Doing business as name
- THROGS NECK EXTENDED CARE FACILITY
- Incorporation date
- 2002-08-23
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- THROGS NECK REHABILITATION & NURSING CENTER
- Affiliation entity name
- EXCELSIOR CARE GROUP
- Affiliation entity id
- 217
- Address line 1
- 707 THROGGS NECK EXPY
- City
- BRONX
- State
- NY
- Zip code
- 104652319