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NPI Code Detail

MEDICARE: HIGHGATE LTC MANGEMENT LLC

MEDICARE: HIGHGATE LTC MANGEMENT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility4161302NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487647889
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHGATE LTC MANGEMENT LLC
Provider Business Mailing Address
First Line : 100 NEW TURNPIKE RD
Second Line :
City : TROY
State : NY
Zip : 12182-1412
Country : US
Telephone Number : 518-235-1410
Fax Number : 518-235-1632
Provider Business Practice Location Address
First Line : 100 NEW TURNPIKE RD
Second Line :
City : TROY
State : NY
Zip : 12182-1412
Country : US
Telephone Number : 518-235-1410
Fax Number : 518-235-1632
Authorized Official
Title or Position : LHA AS RECEIVER
Name : MR. DAVID LAWLER
Credential :
Telephone Number : 203-305-2318
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/17/2008

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Directions to “HIGHGATE LTC MANGEMENT LLC ” Practice Location

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