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General NPI Number Information
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NPI Number | 1750897823
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Entity Type | Organization
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Legal Business Name | HAMPTON NH OPERATING LLC
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 78 OLD COUNTRY RD
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1219
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Country | US
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Telephone | 718-360-8083
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Fax | 718-380-0455
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Provider Business Mailing Address
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Address Line | 460 BAYVIEW AVE
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City | INWOOD
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State | NY
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Zip | 11096-1702
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Country | US
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Telephone | 718-360-8083
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Fax | 718-380-0455
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SHLOMO BOEHM
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Credential |
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Telephone | 718-360-8083
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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 | 5158301N
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License Number State | NY
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