=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235294547
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GLEN ARDEN, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2006
-----------------------------------------------------
Last Update Date | 04/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 214 HARRIMAN DRIVE
-----------------------------------------------------
City | GOSHEN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10924-2410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-360-1200
-----------------------------------------------------
Fax | 845-291-3833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 214 HARRIMAN DR
-----------------------------------------------------
City | GOSHEN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10924-2422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-360-1400
-----------------------------------------------------
Fax | 845-291-3833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PATIENT FINANCE MANAGER
-----------------------------------------------------
Name | JENNIFER ALEXANDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-810-0464
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 3523303N
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------