Provider Demographics
NPI:1386633758
Name:VILLA FRANCES AT THE KNOLLS
Entity Type:Organization
Organization Name:VILLA FRANCES AT THE KNOLLS
Other - Org Name:SCHERVIER PAVILION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-987-5710
Mailing Address - Street 1:22 VAN DUZER PL
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1014
Mailing Address - Country:US
Mailing Address - Phone:845-987-5710
Mailing Address - Fax:845-987-1368
Practice Address - Street 1:22 VAN DUZER PL
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1014
Practice Address - Country:US
Practice Address - Phone:845-987-5710
Practice Address - Fax:845-987-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY015163OtherEMPIRE BLUE CROSS
NYA767936OtherOXFORD PROVIDER ID
NY01588710Medicaid
NY015163OtherEMPIRE BLUE CROSS