Organization
EDEN PARK HEALTH SERVICES, INC.
Active
Other names
Eden Park Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GLOCK (PRESIDENT)
(518) 436-4731
Entity
Organization
Contact information
Practice address
100 FRANKLIN ST, POUGHKEEPSIE, NY 12601-4341
(845) 454-4100
Mailing address
22 HOLLAND AVE, ALBANY, NY 12209-1713
(518) 436-4731
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1302305N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312309
—
NY
Enumeration date
11/08/2006
Last updated
08/22/2020
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