- Enrollment id
- O20120710000604
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1669739207
- Multiple npi flag
- N
- Ccn
- 335301
- Associate id
- 4486819877
- Organization name
- ST JAMES OPERATING LLC
- Doing business as name
- ST. JAMES REHABILITATION & HEALTHCARE CENTER
- Incorporation date
- 2011-10-06
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ST JAMES REHABILITATION & HEALTHCARE CENTER
- Affiliation entity name
- CARERITE CENTERS
- Affiliation entity id
- 110
- Address line 1
- 275 MORICHES RD
- City
- SAINT JAMES
- State
- NY
- Zip code
- 117802150