Provider Demographics
NPI:1023005329
Name:NEW SANS SOUCI NURSING HOME,LLC
Entity Type:Organization
Organization Name:NEW SANS SOUCI NURSING HOME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR/ASST ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RIVKA
Authorized Official - Middle Name:H
Authorized Official - Last Name:GELBTUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-423-9800
Mailing Address - Street 1:115 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2903
Mailing Address - Country:US
Mailing Address - Phone:914-423-9800
Mailing Address - Fax:914-965-3741
Practice Address - Street 1:115 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2903
Practice Address - Country:US
Practice Address - Phone:914-423-9800
Practice Address - Fax:914-965-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5907310N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00308714Medicaid