- Enrollment id
- O20120703000000
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1912264565
- Multiple npi flag
- N
- Ccn
- 335297
- Associate id
- 2567627268
- Organization name
- ROCKVILLE OPERATING LLC
- Doing business as name
- THE GRAND PAVILION FOR REHABILITATION AND NURSING AT ROCKVILLE CENTER
- Incorporation date
- 2011-09-16
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- THE GRAND PAVILION FOR REHAB & NURSING AT ROCKVILLE CENTRE
- Affiliation entity name
- CARERITE CENTERS
- Affiliation entity id
- 110
- Address line 1
- 41 MAINE AVE
- City
- ROCKVILLE CENTRE
- State
- NY
- Zip code
- 115703614