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General NPI Number Information
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NPI Number | 1053659300
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Entity Type | Organization
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Legal Business Name | LIME KILN ELEMENATRY SCHOOL
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 105 S MADISON AVE
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City | SPRING VALLEY
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State | NY
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Zip | 10977-5474
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Country | US
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Telephone | 184-557-7628
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Fax |
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Provider Business Mailing Address
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Address Line | 35 COUNTY ROAD 84
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City | SUFFERN
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State | NY
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Zip | 10901
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Country | US
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Telephone | 845-577-6283
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Fax |
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Authorized Official
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Title or Position | NURSE
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Name | DIANA KELLY
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Credential |
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Telephone | 845-577-6283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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