- Enrollment id
- O20200213000623
- Enrollment state
- ME
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1982256897
- Multiple npi flag
- N
- Ccn
- 205086
- Associate id
- 0244666139
- Organization name
- PINNACLE GROUP OF HUDSON VALLEY III LLC
- Incorporation date
- 2019-01-14
- Incorporation state
- ME
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PINNACLE HEALTH & REHAB AT N BERWICK
- Address line 1
- 47 ELM ST
- City
- NORTH BERWICK
- State
- ME
- Zip code
- 039066724