Organization
LACONIA NURSING HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY EBOH 718 881 4370 (CNA)
(646) 305-8048
Entity
Organization
Contact information
Practice address
3468 FENTON AVE, APARTMENT 1B, BRONX, NY 10469-2032
(646) 305-8048
Mailing address
3468 FENTON AVE, APARTMENT 1B, BRONX, NY 10469-2032
(646) 305-8048
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
323040
NY
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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