Provider Demographics
NPI:1679098636
Name:NORTH STRABANE RETIREMENT VILLAGE LLC
Entity Type:Organization
Organization Name:NORTH STRABANE RETIREMENT VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-561-1800
Mailing Address - Street 1:1800 ROCKAWAY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1668
Mailing Address - Country:US
Mailing Address - Phone:516-561-1800
Mailing Address - Fax:
Practice Address - Street 1:200 TANDEM VILLAGE RD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-6300
Practice Address - Country:US
Practice Address - Phone:724-743-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility