Provider Demographics
NPI:1821125170
Name:KRNH INC
Entity Type:Organization
Organization Name:KRNH INC
Other - Org Name:NORTHEAST CENTER FOR SPECIAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-336-3500
Mailing Address - Street 1:300 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE KATRINE
Mailing Address - State:NY
Mailing Address - Zip Code:12449-5340
Mailing Address - Country:US
Mailing Address - Phone:845-336-3500
Mailing Address - Fax:845-336-7899
Practice Address - Street 1:300 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5340
Practice Address - Country:US
Practice Address - Phone:845-336-3500
Practice Address - Fax:845-336-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01928716Medicaid
NY5501310NOtherOPERATING CERTIFICATE #
NY01928716Medicaid