- Enrollment id
- O20100127000008
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1710966379
- Multiple npi flag
- N
- Ccn
- 335050
- Associate id
- 6507908787
- Organization name
- MARY MANNING WALSH NURSING HOME CO INC
- Doing business as name
- ARCHCARE
- Incorporation date
- 1966-11-02
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- MARY MANNING WALSH NURSING HOME CO INC
- Affiliation entity name
- ARCHCARE
- Affiliation entity id
- 43
- Address line 1
- 1339 YORK AVE
- City
- NEW YORK
- State
- NY
- Zip code
- 100214707