Provider Demographics
NPI:1801352091
Name:JAFFREY REHABILITATION AND NURSING CENTER LLC
Entity type:Organization
Organization Name:JAFFREY REHABILITATION AND NURSING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:PENINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-709-4910
Mailing Address - Street 1:20 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:JAFFREY
Mailing Address - State:NH
Mailing Address - Zip Code:03452-6631
Mailing Address - Country:US
Mailing Address - Phone:718-974-0266
Mailing Address - Fax:
Practice Address - Street 1:20 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:JAFFREY
Practice Address - State:NH
Practice Address - Zip Code:03452-6631
Practice Address - Country:US
Practice Address - Phone:718-974-0266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility