- Enrollment id
- O20140312000746
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1841613163
- Multiple npi flag
- N
- Ccn
- 335545
- Associate id
- 2163652256
- Organization name
- SGRNC LLC
- Doing business as name
- KING DAVID CENTER FOR NURSING AND REHABILITATION
- Incorporation date
- 2013-06-06
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- KING DAVID CENTER FOR NURSING AND REHABILITATION
- Affiliation entity name
- ALLURE GROUP
- Affiliation entity id
- 734
- Address line 1
- 2266 CROPSEY AVE
- City
- BROOKLYN
- State
- NY
- Zip code
- 112145706