Organization
TRUSTEES OF THE EASTERN STAR HALL AND HOME OF THE STATE OF NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY FRENCH (ADMINISTRATOR)
(315) 736-9311
Entity
Organization
Contact information
Practice address
8290 STATE ROUTE 69, ORISKANY, NY 13424-0959
(315) 736-9311
(315) 736-3047
Mailing address
PO BOX 959, 8290 STATE ROUTE 69, ORISKANY, NY 13424-0959
(315) 736-9311
(315) 736-3047
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3239300N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00310494
—
NY
Enumeration date
07/31/2006
Last updated
09/08/2015
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