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Organization

QUEENS BOULEVARD EXTENDED CARE FACILITY MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH MALONE CPA (CFO)
(718) 205-0287
Entity
Organization

Contact information

Practice address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0287
(718) 803-0694
Mailing address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0287
(718) 803-0694

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
314000000X
Skilled Nursing Facility
Primary
700341N
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02996110
NY
05
1710672
NY
05
7003410N
NY
Enumeration date
01/31/2014
Last updated
12/15/2021
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