Healthcare Provider Details

I. General information

NPI: 1538817044
Provider Name (Legal Business Name): JACKSON HEIGHTS NURSING AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 NW 22ND ST
MIAMI FL
33142-7742
US

IV. Provider business mailing address

1404 NW 22ND ST
MIAMI FL
33142-7742
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-1050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MOSHE SCHEINER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 845-490-6060