Provider Demographics
NPI:1659352599
Name:HIGHLAND NURSING HOME, INC.
Entity Type:Organization
Organization Name:HIGHLAND NURSING HOME, INC.
Other - Org Name:NORTH COUNTRY NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MENAJEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-882-6400
Mailing Address - Street 1:182 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-3281
Mailing Address - Country:US
Mailing Address - Phone:315-769-9956
Mailing Address - Fax:315-769-9955
Practice Address - Street 1:182 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3281
Practice Address - Country:US
Practice Address - Phone:315-769-9956
Practice Address - Fax:315-769-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4402300N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00565119Medicaid
NY335619Medicare Oscar/Certification