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NPI 1558819862

NPI 1558819862 : FORT TRYON REHABILITATION & HEALTH CARE FACILITY LLC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1558819862
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    Entity Type          |    Organization 
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    Legal Business Name  |    FORT TRYON REHABILITATION & HEALTH CARE FACILITY LLC 
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Dates
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    Enumeration Date     |    09/15/2016
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    Last Update Date     |    09/15/2016
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Provider Practice Location Address
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    Address Line         |    801 W 190TH ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10040-3802
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    Country              |    US
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    Telephone            |    212-543-6400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    801 W 190TH ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10040-3802
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     HELEN  WEBSTER 
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    Credential           |    
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    Telephone            |    718-670-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QA0600X
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    Taxonomy Name        |    Adult Day Care Clinic/Center
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    License Number       |    7002359N
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    License Number State |    NY
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