Provider Demographics
NPI:1902404569
Name:SHENANDOAH HEIGHTS HEALTHCARE LLC
Entity Type:Organization
Organization Name:SHENANDOAH HEIGHTS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KALMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-885-5152
Mailing Address - Street 1:67 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11096-1117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:PA
Practice Address - Zip Code:17976-1332
Practice Address - Country:US
Practice Address - Phone:570-462-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility