- Enrollment id
- O20090120000555
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1639234149
- Multiple npi flag
- N
- Ccn
- 335141
- Associate id
- 7315000262
- Organization name
- MONTCLAIR CARE CENTER INC
- Doing business as name
- EMERGE NURSING AND REHABILITATION AT GLEN COVE
- Incorporation date
- 1998-03-27
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- EMERGE NURSING AND REHABILITATION AT GLEN COVE
- Affiliation entity name
- PARAGON HEALTHNET
- Affiliation entity id
- 395
- Address line 1
- 2 MEDICAL PLZ
- City
- GLEN COVE
- State
- NY
- Zip code
- 115422108