- Enrollment id
- O20070724000504
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1609879915
- Multiple npi flag
- N
- Ccn
- 335792
- Associate id
- 1153422977
- Organization name
- NORTHERN MANHATTAN NURSING HOME INC
- Doing business as name
- NORTHERN MANHATTAN REHABILITATION & NURSING CARE CENTER, INC
- Incorporation date
- 1993-01-01
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- NORTHERN MANHATTAN REHABILITATION AND NURSING CENTER
- Address line 1
- 116E 125TH ST
- City
- NEW YORK
- State
- NY
- Zip code
- 100351612