Provider Demographics
NPI:1174509483
Name:EAST END HEALTHCARE INC
Entity Type:Organization
Organization Name:EAST END HEALTHCARE INC
Other - Org Name:WESTHAMPTON CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-288-0101
Mailing Address - Street 1:78 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11977-1219
Mailing Address - Country:US
Mailing Address - Phone:631-288-0101
Mailing Address - Fax:631-898-0576
Practice Address - Street 1:78 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11977-1219
Practice Address - Country:US
Practice Address - Phone:631-288-0101
Practice Address - Fax:631-898-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5158301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01561724Medicaid
NY335782Medicare ID - Type Unspecified