- Enrollment id
- O20130801000209
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1710328380
- Multiple npi flag
- N
- Ccn
- 335227
- Associate id
- 9739320888
- Organization name
- JOPAL BRONX, LLC
- Doing business as name
- WORKMEN'S CIRCLE MULTI CARE CENTER
- Incorporation date
- 2010-10-28
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WORKMEN'S CIRCLE MULTICARE CENTER
- Affiliation entity name
- CASSENA CARE
- Affiliation entity id
- 119
- Address line 1
- 3155 GRACE AVE
- City
- BRONX
- State
- NY
- Zip code
- 104693134