- Enrollment id
- O20111212000632
- Enrollment state
- MA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1992793509
- Multiple npi flag
- N
- Ccn
- 225402
- Associate id
- 6507031085
- Organization name
- CLIFTON GERIATRIC CENTER
- Doing business as name
- CLIFTON REHABILITATIVE NURSING CENTER
- Incorporation date
- 1979-01-04
- Incorporation state
- MA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CLIFTON REHABILITATION NURSING CENTER
- Affiliation entity name
- MICHAEL FEIST
- Affiliation entity id
- 769
- Address line 1
- 500 WILBUR AVE
- City
- SOMERSET
- State
- MA
- Zip code
- 027252051