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Organization

PLEASANTVILLE OPERATING LLC

Active
Parent organization
PLEASANTVILLE VENTURES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PLEASANTVILLE VENTURES LLC
Authorized official
CHARLES-EDOUARD GROS (MANAGING MEMBER)
(718) 360-8083
Entity
Organization

Contact information

Practice address
1100 CLEMATIS AVE, PLEASANTVILLE, NJ 08232-3302
(718) 360-8083
Mailing address
13742 71ST AVE, FLUSHING, NY 11367-1939
(718) 360-8083

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060106
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4462203
NJ
Enumeration date
09/17/2015
Last updated
09/17/2015
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