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NPI 1861006264

NPI 1861006264 : AMBER COURT OF WESTBURY II LLC : WESTBURY, NY

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General NPI Number Information
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    NPI Number           |    1861006264
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMBER COURT OF WESTBURY II LLC 
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Dates
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    Enumeration Date     |    09/02/2020
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    Last Update Date     |    09/02/2020
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Provider Practice Location Address
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    Address Line         |    3400 BRUSH HOLLOW RD 
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    City                 |    WESTBURY
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    State                |    NY
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    Zip                  |    11590-1712
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    Country              |    US
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    Telephone            |    516-334-3838
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1155 E JERSEY ST 
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    City                 |    ELIZABETH
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    State                |    NJ
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    Zip                  |    07201-2310
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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    |    CFO
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    Name                 |     RAPHAEL  WEISS 
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    Credential           |    
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    Telephone            |    516-334-3838
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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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