- Enrollment id
- O20220602000123
- Enrollment state
- NC
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1972261808
- Multiple npi flag
- N
- Ccn
- 345233
- Associate id
- 9830577956
- Organization name
- DEER PARK HEALTH AND REHABILITATION SNF LLC
- Doing business as name
- DEER PARK HEALTH AND REHABILITATION
- Incorporation date
- 2021-12-09
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- DEER PARK HEALTH AND REHABILITATION
- Affiliation entity name
- BRIGHTON HEALTHCARE
- Affiliation entity id
- 848
- Address line 1
- 306 DEER PARK RD
- City
- NEBO
- State
- NC
- Zip code
- 287618746