Provider Demographics
NPI:1821209891
Name:TARRYTOWN HALL CARE CENTER LLC
Entity Type:Organization
Organization Name:TARRYTOWN HALL CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-631-2600
Mailing Address - Street 1:20 WOOD CT
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3108
Mailing Address - Country:US
Mailing Address - Phone:914-631-2600
Mailing Address - Fax:914-631-2821
Practice Address - Street 1:20 WOOD CT
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3108
Practice Address - Country:US
Practice Address - Phone:914-631-2600
Practice Address - Fax:914-631-2821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5911301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5911301NOtherSTATE OPERATING CERTIFICA
NY01247350Medicaid
NY5911301NOtherSTATE OPERATING CERTIFICA
NY5911301NOtherSTATE OPERATING CERTIFICA