Provider Demographics
NPI:1750377800
Name:LITTLE FLOWER FOR REHABILITATION & NURSING
Entity type:Organization
Organization Name:LITTLE FLOWER FOR REHABILITATION & NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-581-6400
Mailing Address - Street 1:340 EAST MONTAUK HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2820
Mailing Address - Country:US
Mailing Address - Phone:631-581-6400
Mailing Address - Fax:631-581-6018
Practice Address - Street 1:340 EAST MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2820
Practice Address - Country:US
Practice Address - Phone:631-581-6400
Practice Address - Fax:631-581-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5154308N314000000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00311188Medicaid
NY030856001Medicare NSC
NY335401Medicare Oscar/Certification