Provider Demographics
NPI:1376738419
Name:NEW YORK SENIORCARE IN THE VALLEY LLC
Entity Type:Organization
Organization Name:NEW YORK SENIORCARE IN THE VALLEY LLC
Other - Org Name:VALLEY VISTA ADULT HOME/ALP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:845-691-7400
Mailing Address - Street 1:141 NORTH RD
Mailing Address - Street 2:P.O. BOX 1127
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1037
Mailing Address - Country:US
Mailing Address - Phone:845-691-7400
Mailing Address - Fax:845-691-3787
Practice Address - Street 1:141 NORTH ROAD
Practice Address - Street 2:VALLEY VISTA ADULT HOME/ALP
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-1037
Practice Address - Country:US
Practice Address - Phone:845-691-7400
Practice Address - Fax:845-691-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740 F 074310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01453016Medicaid