Provider Demographics
NPI:1629572508
Name:CHERRY LANE OPERATING GROUP LLC
Entity Type:Organization
Organization Name:CHERRY LANE OPERATING GROUP LLC
Other - Org Name:CHERRY LANE NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-567-0402
Mailing Address - Street 1:14C 53RD ST STE 220
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2644
Mailing Address - Country:US
Mailing Address - Phone:877-567-0402
Mailing Address - Fax:
Practice Address - Street 1:9001 CHERRY LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1120
Practice Address - Country:US
Practice Address - Phone:301-498-8558
Practice Address - Fax:301-317-1851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care