Organization
PINE HAVEN OPERATING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BLEIER (MEMBER)
(845) 641-0303
Entity
Organization
Contact information
Practice address
201 MAIN STREET, PHILMONT, NY 12565
(518) 672-7408
Mailing address
201 MAIN STREET, PHILMONT, NY 12565
(518) 672-7408
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NY
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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