Organization
GREEN VALLEY SNF LLC
Active
Other names
Pinnacle Rehab & Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FAIGE SHOSHANA (DIRECTOR OF CONTRACTING)
(732) 551-4803
Entity
Organization
Contact information
Practice address
3034 S DUPONT BLVD, SMYRNA, DE 19977-1898
(302) 653-5085
Mailing address
400 RELLA BLVD STE 200, MONTEBELLO, NY 10901-4239
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1160
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001088411
—
DE
05
—
0001088512
—
DE
01
—
155A20
BLUE CROSS
—
Enumeration date
04/10/2006
Last updated
06/19/2020
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