Healthcare Provider Details

I. General information

NPI: 1013278746
Provider Name (Legal Business Name): GUILDERLAND CENTER REHABILITATION & EXTENDED CARE FACILITY OP CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 MAIN STREET 428 RT. 146
GUILDERLAND CENTER NY
12085
US

IV. Provider business mailing address

127 MAIN ST.REET 428 RT. 146
GUILDERLAND CENTER NY
12085
US

V. Phone/Fax

Practice location:
  • Phone: 518-382-2427
  • Fax: 518-382-2429
Mailing address:
  • Phone: 518-861-5141
  • Fax: 518-861-5437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0155303N
License Number StateNY

VIII. Authorized Official

Name: MS. CHRISTINE E SLEDZIEWSKI
Title or Position: CONTROLLER
Credential:
Phone: 518-382-2427