Provider Demographics
NPI:1306918685
Name:ELMHURST CARE CENTER INC
Entity type:Organization
Organization Name:ELMHURST CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AST ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOSSI
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-247-6141
Mailing Address - Street 1:10017 23RD AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369
Mailing Address - Country:US
Mailing Address - Phone:718-205-8100
Mailing Address - Fax:718-507-7503
Practice Address - Street 1:10017 23RD AVENUE
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369
Practice Address - Country:US
Practice Address - Phone:718-205-8100
Practice Address - Fax:718-507-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01945019Medicaid
NY335814Medicare Oscar/Certification