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General NPI Number Information
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NPI Number | 1366067738
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Entity Type | Organization
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Legal Business Name | FOUNTAINVIEW AT COLLEGE RD
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 2000 FOUNTAINVIEW DR
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City | MONSEY
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State | NY
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Zip | 10952-2875
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Country | US
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Telephone | 845-426-6757
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 FOUNTAINVIEW DR
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City | MONSEY
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State | NY
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Zip | 10952-2875
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Country | US
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Telephone | 845-426-6757
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. GEDALIA KLEIN
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Credential | LNHA
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Telephone | 845-629-1204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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