Organization
KING STREET HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILNER (ADMINISTRATOR)
(914) 937-5800
Entity
Organization
Contact information
Practice address
787 KING ST, RYE BROOK, NY 10573-1225
(914) 937-5800
(914) 949-6986
Mailing address
787 KING ST, RYE BROOK, NY 10573-1225
(914) 937-5800
(914) 949-6986
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5906300N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312978
—
NY
Enumeration date
04/03/2006
Last updated
11/03/2014
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