Organization
COUNTY OF SULLIVAN
Active
Other names
SULLIVAN COUNTY ADULT CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHENNOY WELLINGTON LNHA (ADMINISTRATOR)
(845) 292-8640
Entity
Organization
Contact information
Practice address
256 SUNSET LAKE RD., LIBERTY, NY 12754-0671
(845) 292-8640
(845) 513-2177
Mailing address
PO BOX 671, LIBERTY, NY 12754-0671
(845) 292-8640
(845) 513-2177
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000X
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01415301
—
NY
Enumeration date
01/19/2007
Last updated
04/16/2015
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