Provider Demographics
NPI:1477603728
Name:MARCHAND MANOR, LLC
Entity Type:Organization
Organization Name:MARCHAND MANOR, LLC
Other - Org Name:MARCHAND MANOR ALP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PESSOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-284-2357
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:ROUTE 10 131 MAIN STREET
Mailing Address - City:SHARON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13459-0265
Mailing Address - Country:US
Mailing Address - Phone:518-284-2357
Mailing Address - Fax:518-284-2357
Practice Address - Street 1:131 MAIN STREET
Practice Address - Street 2:COUNTY HIGHWAY ROUTE 10
Practice Address - City:SHARON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13459-0265
Practice Address - Country:US
Practice Address - Phone:518-284-2357
Practice Address - Fax:518-284-2357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0782L001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility