Provider Demographics
NPI:1407841802
Name:JAMAICA HOSPITAL NURSING HOME CO INC
Entity Type:Organization
Organization Name:JAMAICA HOSPITAL NURSING HOME CO INC
Other - Org Name:TRUMP PAVILION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-206-5101
Mailing Address - Street 1:89-40 135ST STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2898
Mailing Address - Country:US
Mailing Address - Phone:718-206-5101
Mailing Address - Fax:718-206-5130
Practice Address - Street 1:89-40 135ST STREET
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2898
Practice Address - Country:US
Practice Address - Phone:718-206-5101
Practice Address - Fax:718-206-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003346N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY308952Medicaid
NY00308952Medicaid
NY308952Medicaid