Provider Demographics
NPI:1841262904
Name:LAWRENCE NURSING CARE CENTER, INC.
Entity type:Organization
Organization Name:LAWRENCE NURSING CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-945-0400
Mailing Address - Street 1:350 BEACH 54TH ST
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1782
Mailing Address - Country:US
Mailing Address - Phone:718-945-0400
Mailing Address - Fax:718-945-5954
Practice Address - Street 1:350 BEACH 54TH ST
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1782
Practice Address - Country:US
Practice Address - Phone:718-945-0400
Practice Address - Fax:718-634-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00309577Medicaid
NY335415Medicare Oscar/Certification