Healthcare Provider Details

I. General information

NPI: 1083693576
Provider Name (Legal Business Name): FERNCLIFF NURSING HOME COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 FERNCLIFF DRIVE
RHINEBECK NY
12572
US

IV. Provider business mailing address

21 FERNCLIFF DR
RHINEBECK NY
12572-2068
US

V. Phone/Fax

Practice location:
  • Phone: 845-876-2011
  • Fax: 845-876-7119
Mailing address:
  • Phone: 646-633-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1327300N
License Number StateNY

VIII. Authorized Official

Name: ANNMARIE COVONE
Title or Position: SRVP CFO
Credential:
Phone: 646-633-4702