- Enrollment id
- O20120904000434
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952395626
- Multiple npi flag
- N
- Ccn
- 335644
- Associate id
- 4587555362
- Organization name
- BRONX HARBOR HEALTH CARE COMPLEX INC
- Doing business as name
- KINGS HARBOR MULTICARE CENTER
- Incorporation date
- 1994-06-12
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- KINGS HARBOR MULTICARE CENTE
- Address line 1
- 2000 EAST GUN HILL RD
- City
- BRONX
- State
- NY
- Zip code
- 104696016