Organization
OUR LADY OF CONSOLATION GERIATRIC CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J HAIGHT (DIRECTOR OF FINANCE)
(631) 465-6442
Entity
Organization
Contact information
Practice address
111 BEACH DR, WEST ISLIP, NY 11795-4929
(631) 587-1600
(631) 587-3263
Mailing address
111 BEACH DR, WEST ISLIP, NY 11795-4929
(631) 587-1600
(631) 587-3263
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
5154901L
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00830355
—
NY
01
—
5154901L
OPERATING CERTIFICATE #
NY
Enumeration date
04/06/2006
Last updated
03/23/2012
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