Provider Demographics
NPI:1386787216
Name:NEW FRANKLIN REHABILIATION AND HEALTH CARE FACILITY, LLC
Entity type:Organization
Organization Name:NEW FRANKLIN REHABILIATION AND HEALTH CARE FACILITY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:TULI
Authorized Official - Middle Name:
Authorized Official - Last Name:FASTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-670-6300
Mailing Address - Street 1:4515 162ND ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3157
Mailing Address - Country:US
Mailing Address - Phone:718-670-6310
Mailing Address - Fax:718-670-6311
Practice Address - Street 1:4515 162ND ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3157
Practice Address - Country:US
Practice Address - Phone:718-670-6310
Practice Address - Fax:718-670-6311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW FRANKLIN REHABILIATION AND HEALTH CARE FACILITY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-14
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
NY7003402M314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02444008Medicaid