Provider Demographics
NPI:1154084713
Name:EMERALD NURSING & REHAB LEGACY POINTE
Entity Type:Organization
Organization Name:EMERALD NURSING & REHAB LEGACY POINTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-504-9797
Mailing Address - Street 1:945 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1604
Mailing Address - Country:US
Mailing Address - Phone:516-399-3051
Mailing Address - Fax:
Practice Address - Street 1:3110 SCOTT CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-2604
Practice Address - Country:US
Practice Address - Phone:516-399-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility