Provider Demographics
NPI:1720598261
Name:BIRCHWOOD PLACE SNF LLC
Entity Type:Organization
Organization Name:BIRCHWOOD PLACE SNF LLC
Other - Org Name:BIRCHWOOD NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KARMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-746-5010
Mailing Address - Street 1:368 NEW HEMPSTEAD RD STE 309
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:395 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-3806
Practice Address - Country:US
Practice Address - Phone:570-735-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility