- Enrollment id
- O20040622000524
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1932215209
- Multiple npi flag
- N
- Ccn
- 335130
- Associate id
- 6103801386
- Organization name
- CLEARVIEW OPERATING CO. LLC
- Doing business as name
- THE GRAND REHABILITATION AND NURSING AT QUEENS
- Incorporation date
- 2002-06-28
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- QUEENS CENTER FOR REHABILITATION AND NURSING
- Affiliation entity name
- THE GRAND HEALTHCARE
- Affiliation entity id
- 509
- Address line 1
- 15715 19TH AVE
- City
- WHITESTONE
- State
- NY
- Zip code
- 113573820