- Enrollment id
- O20101221000957
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1982913109
- Multiple npi flag
- N
- Ccn
- 335470
- Associate id
- 3577751320
- Organization name
- BORO PARK OPERATING CO LLC
- Doing business as name
- BORO PARK CENTER FOR REHABILITATION AND HEALTH CARE
- Incorporation date
- 2009-07-03
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BORO PARK CENTER FOR REHABILITATION AND HEALTHCARE
- Affiliation entity name
- CENTERS HEALTH CARE
- Affiliation entity id
- 127
- Address line 1
- 4915 10TH AVE
- City
- BROOKLYN
- State
- NY
- Zip code
- 112193301