Provider Demographics
NPI:1275559155
Name:ST. FRANCES CENTER AT THE KNOLLS
Entity Type:Organization
Organization Name:ST. FRANCES CENTER AT THE KNOLLS
Other - Org Name:MT. ALVERNO ADULT HOME & ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-987-5627
Mailing Address - Street 1:20 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-987-5627
Mailing Address - Fax:845-987-5641
Practice Address - Street 1:20 GRAND ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1035
Practice Address - Country:US
Practice Address - Phone:845-987-5761
Practice Address - Fax:845-987-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01687269Medicaid