- Enrollment id
- O20110811000595
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1881622785
- Multiple npi flag
- N
- Ccn
- 335472
- Associate id
- 9234308099
- Organization name
- MIDWAY NURSING HOME, INC.
- Incorporation date
- 1998-07-17
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- CENTRAL QUEENS REHAB & NURSING CENTER
- Address line 1
- 6995 QUEENS MIDTOWN EXPY
- City
- MASPETH
- State
- NY
- Zip code
- 113781922