Provider Demographics
NPI:1194754366
Name:DAUGHTERS OF SARAH NURSING CENTER, INC.
Entity type:Organization
Organization Name:DAUGHTERS OF SARAH NURSING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-456-7831
Mailing Address - Street 1:180 WASHINGTON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5347
Mailing Address - Country:US
Mailing Address - Phone:518-456-7831
Mailing Address - Fax:518-456-1563
Practice Address - Street 1:180 WASHINGTON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5347
Practice Address - Country:US
Practice Address - Phone:518-456-7831
Practice Address - Fax:518-456-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0101312N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000401069000OtherBLUESHIELD OF NENY
NY10019867OtherCAPITAL DISTRICT PHYSICIA
NY00310361Medicaid
NY01117266Medicaid
NY00310361Medicaid