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General NPI Number Information
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NPI Number | 1699850669
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Entity Type | Organization
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Legal Business Name | GREATER HARLEM NURSING HOME AND REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 30 WEST 138TH STREET
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City | NEW YORK
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State | NY
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Zip | 10037-1710
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Country | US
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Telephone | 212-690-7400
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Fax | 212-926-1799
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Provider Business Mailing Address
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Address Line | 30 WEST 138TH STREET
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City | NEW YORK
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State | NY
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Zip | 10037-1710
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Country | US
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Telephone | 212-690-7400
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Fax | 212-926-1799
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MR. THOMAS M. FORISTALL
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Credential |
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Telephone | 212-690-7400
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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 | 7002341N
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License Number State | NY
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