Provider Demographics
NPI:1164413977
Name:GARDEN CARE CENTER INC.
Entity Type:Organization
Organization Name:GARDEN CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-775-2100
Mailing Address - Street 1:135 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2500
Mailing Address - Country:US
Mailing Address - Phone:516-775-2100
Mailing Address - Fax:516-775-3092
Practice Address - Street 1:135 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-2500
Practice Address - Country:US
Practice Address - Phone:516-775-2100
Practice Address - Fax:516-775-3092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207RG0300X314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01986694Medicaid
NY5186120001Medicare NSC
NY01986694Medicaid