Provider Demographics
NPI:1235460874
Name:CROWNHILL NURSING & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:CROWNHILL NURSING & REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-535-3801
Mailing Address - Street 1:805 AVENUE L
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5114
Mailing Address - Country:US
Mailing Address - Phone:718-535-3801
Mailing Address - Fax:718-535-1019
Practice Address - Street 1:505 W CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5445
Practice Address - Country:US
Practice Address - Phone:972-278-3566
Practice Address - Fax:972-278-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128569314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014744Medicaid
TX001014744Medicaid