Organization
CL OPERATING LLC
Active
Other names
Crystal Lake Rehabilitation and Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAM STERN (CFO)
(877) 567-0402
Entity
Organization
Contact information
Practice address
999 S MAIN ST, PASCOAG, RI 02859-3522
(877) 567-0402
Mailing address
14C 53RD ST STE 224N, BROOKLYN, NY 11232-2644
(877) 567-0402
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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