- Enrollment id
- O20050519000229
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1790772150
- Multiple npi flag
- N
- Ccn
- 335690
- Associate id
- 4981645090
- Organization name
- WHITE OAKS REHABILITATION AND NURSING CENTER
- Organization type structure
- PARTNERSHIP
- Proprietary nonprofit
- P
- Nursing home provider name
- WHITE OAKS REHABILITATION AND NURSING CENTER
- Address line 1
- 8565 JERICHO TPKE
- City
- WOODBURY
- State
- NY
- Zip code
- 117971804