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General NPI Number Information
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NPI Number | 1972384998
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Entity Type | Organization
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Legal Business Name | SISTER BAY SNF OPCO LLC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 10560 APPLEWOOD RD
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City | SISTER BAY
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State | WI
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Zip | 54234-9005
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Country | US
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Telephone | 718-570-6018
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Fax |
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Provider Business Mailing Address
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Address Line | C/O CONTINUUM HEALTHCARE 180 SYLVAN AVENUE
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632
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Country | US
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Telephone | 718-570-6018
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. DANIEL MANDELBAUM
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Credential | CPA
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Telephone | 718-570-6018
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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 |
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License Number State |
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