Healthcare Provider Details

I. General information

NPI: 1235294547
Provider Name (Legal Business Name): GLEN ARDEN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 HARRIMAN DRIVE
GOSHEN NY
10924-2410
US

IV. Provider business mailing address

214 HARRIMAN DR
GOSHEN NY
10924-2422
US

V. Phone/Fax

Practice location:
  • Phone: 845-360-1200
  • Fax: 845-291-3833
Mailing address:
  • Phone: 845-360-1400
  • Fax: 845-291-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3523303N
License Number StateNY

VIII. Authorized Official

Name: JENNIFER ALEXANDER
Title or Position: PATIENT FINANCE MANAGER
Credential:
Phone: 914-810-0464