Organization
SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH ROSSO (CFO)
(716) 829-1554
Entity
Organization
Contact information
Practice address
282 RIVERSIDE DR, JOHNSON CITY, NY 13790-2727
(607) 729-9206
(607) 797-3229
Mailing address
282 RIVERSIDE DR, JOHNSON CITY, NY 13790-2727
(607) 729-9206
(607) 797-3229
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
314000000X
Skilled Nursing Facility
Primary
0303307N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00311037
—
NY
05
—
00811629
—
NY
01
—
0303307N
OPERATING CERTIFICATE
NY
Enumeration date
11/11/2005
Last updated
09/26/2024
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