Provider Demographics
NPI:1114913902
Name:TOLSTOY FOUNDATION NURSING HOME COMPANY INC
Entity Type:Organization
Organization Name:TOLSTOY FOUNDATION NURSING HOME COMPANY INC
Other - Org Name:TOLSTOY FOUNDATION REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-268-6813
Mailing Address - Street 1:100 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2339
Mailing Address - Country:US
Mailing Address - Phone:845-268-6813
Mailing Address - Fax:845-268-7673
Practice Address - Street 1:100 LAKE RD
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2339
Practice Address - Country:US
Practice Address - Phone:845-268-6813
Practice Address - Fax:845-268-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4350301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00309068Medicaid
NY335311Medicare Oscar/Certification
NY00309068Medicaid