Healthcare Provider Details

I. General information

NPI: 1548729619
Provider Name (Legal Business Name): FOREST CITY CARE CONTINUUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 DELAWARE ST
FOREST CITY PA
18421-1005
US

IV. Provider business mailing address

99 W HAWTHORNE AVE STE 508
VALLEY STREAM NY
11580-6101
US

V. Phone/Fax

Practice location:
  • Phone: 570-785-3005
  • Fax:
Mailing address:
  • Phone: 718-879-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. AKIVA GLATZER
Title or Position: MEMBER
Credential:
Phone: 718-879-3030