Provider Demographics
NPI:1609863232
Name:JOPAL LLC BARNWELL NURSING & REHAB CTR.
Entity Type:Organization
Organization Name:JOPAL LLC BARNWELL NURSING & REHAB CTR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RESIDENT CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:JENNIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:518-758-6222
Mailing Address - Street 1:3230 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-2303
Mailing Address - Country:US
Mailing Address - Phone:518-758-6222
Mailing Address - Fax:518-758-9199
Practice Address - Street 1:3230 CHURCH ST
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-2303
Practice Address - Country:US
Practice Address - Phone:518-758-6222
Practice Address - Fax:518-758-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1023301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00310632Medicaid
NY335565Medicare ID - Type Unspecified
NY00310632Medicaid