Healthcare Provider Details

I. General information

NPI: 1245910850
Provider Name (Legal Business Name): BV HARRISON OPERATOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 LAKE STREET
HARRISON NY
10604
US

IV. Provider business mailing address

600 LAKE STREET
HARRISON NY
10604
US

V. Phone/Fax

Practice location:
  • Phone: 914-435-8388
  • Fax: 914-435-8389
Mailing address:
  • Phone: 914-435-8388
  • Fax: 914-435-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MARILYNN DUKER
Title or Position: PRESIDENT/SOLE MEMBER
Credential:
Phone: 410-962-0595