- Enrollment id
- O20110811000541
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1629006937
- Multiple npi flag
- N
- Ccn
- 335327
- Associate id
- 5294904058
- Organization name
- BRIDGE VIEW NURSING HOME, INC.
- Incorporation date
- 1998-07-17
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- BRIDGE VIEW NURSING HOME
- Affiliation entity name
- THE GRAND HEALTHCARE
- Affiliation entity id
- 509
- Address line 1
- 143-10 20TH AVE
- City
- WHITESTONE
- State
- NY
- Zip code
- 113573046