- Enrollment id
- O20100127000158
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1790772242
- Multiple npi flag
- N
- Ccn
- 335677
- Associate id
- 4587706783
- Organization name
- SHEEPSHEAD NURSING AND REHABILITATION CENTER LLC
- Incorporation date
- 2006-09-25
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SHEEPSHEAD NURSING & REHABILITATION CENTER
- Address line 1
- 2840 KNAPP ST
- City
- BROOKLYN
- State
- NY
- Zip code
- 112351112