- Enrollment id
- O20111129000096
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1710050554
- Multiple npi flag
- N
- Ccn
- 335505
- Associate id
- 8820262033
- Organization name
- HIGHLAND CARE CENTER, INC
- Incorporation date
- 1989-02-27
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- HIGHLAND CARE CENTER
- Address line 1
- 9131 175TH ST
- City
- JAMAICA
- State
- NY
- Zip code
- 114325517