Healthcare Provider Details

I. General information

NPI: 1609863232
Provider Name (Legal Business Name): JOPAL LLC BARNWELL NURSING & REHAB CTR.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 CHURCH ST
VALATIE NY
12184-2303
US

IV. Provider business mailing address

3230 CHURCH ST
VALATIE NY
12184-2303
US

V. Phone/Fax

Practice location:
  • Phone: 518-758-6222
  • Fax: 518-758-9199
Mailing address:
  • Phone: 518-758-6222
  • Fax: 518-758-9199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1023301N
License Number StateNY

VIII. Authorized Official

Name: MRS. ROSALIE JENNIE JOHNSON
Title or Position: DIRECTOR OF RESIDENT CARE
Credential: R.N.C.
Phone: 518-758-6222