Organization
KENNETH GAUL II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MADELINE C BUTLER LNHA (ADMINISTRATOR)
(631) 878-4400
Entity
Organization
Contact information
Practice address
6 FROWEIN RD, CENTER MORICHES, NY 11934-1604
(631) 878-4400
(631) 878-6865
Mailing address
6 FROWEIN RD, CENTER MORICHES, NY 11934-1604
(631) 878-4400
(631) 878-6865
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
5151313N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00311399
—
NY
Enumeration date
12/01/2006
Last updated
01/28/2008
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