- Enrollment id
- O20070104000073
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1841365509
- Multiple npi flag
- N
- Ccn
- 335178
- Associate id
- 7113927765
- Organization name
- PROSPECT PARK OPERATING, LLC
- Incorporation date
- 2005-12-27
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BROOKLYN CENTER FOR REHABILITATION AND RESIDENTIAL HEALTH CARE
- Affiliation entity name
- CENTERS HEALTH CARE
- Affiliation entity id
- 127
- Address line 1
- 170 BUFFALO AVE
- City
- BROOKLYN
- State
- NY
- Zip code
- 112132421