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General NPI Number Information
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NPI Number | 1508801903
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Entity Type | Organization
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Legal Business Name | JANSEN ROAD NURSING AND REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 1 JANSEN RD
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City | NEW PALTZ
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State | NY
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Zip | 12561-3811
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Country | US
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Telephone | 845-255-0830
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Fax | 845-255-0855
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Provider Business Mailing Address
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Address Line | 1 JANSEN RD
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City | NEW PALTZ
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State | NY
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Zip | 12561-3811
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Country | US
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Telephone | 845-255-0830
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Fax | 845-255-0855
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Authorized Official
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Title or Position | CEO
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Name | PATRICK MARTONE
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Credential |
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Telephone | 518-346-9640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 5522302N
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License Number State | NY
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