Provider Demographics
NPI:1417954959
Name:COSDEN, LLC
Entity Type:Organization
Organization Name:COSDEN, LLC
Other - Org Name:PALATINE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-673-5212
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:PALATINE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13428-0425
Mailing Address - Country:US
Mailing Address - Phone:518-673-5212
Mailing Address - Fax:518-673-5911
Practice Address - Street 1:154 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:PALATINE BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13428-9715
Practice Address - Country:US
Practice Address - Phone:518-673-5212
Practice Address - Fax:518-673-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2851301N314000000X
NY2827000N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00313011Medicaid
NY00313011Medicaid