- Enrollment id
- O20100115000194
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1861495202
- Multiple npi flag
- N
- Ccn
- 335718
- Associate id
- 3173665015
- Organization name
- WOODMERE REHABILITATION AND HEALTH CARE CENTER INC
- Doing business as name
- THE FIVE TOWNS PREMIER REHABILITATION & NURSING CENTER
- Incorporation date
- 1996-08-22
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- THE FIVE TOWNS PREMIER REHABILITATION & NURSING CENTER
- Affiliation entity name
- BENJAMIN LANDA
- Affiliation entity id
- 646
- Address line 1
- 1050 CENTRAL AVE
- City
- WOODMERE
- State
- NY
- Zip code
- 115981266