Basic Information
| Provider Information | |||||||||
| NPI: | 1306875141 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TOWNHOUSE OPERATING COMPANY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 755 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115531111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165651900 | ||||||||
| FaxNumber: | 5165655816 | ||||||||
| Practice Location | |||||||||
| Address1: | 755 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115531111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165651900 | ||||||||
| FaxNumber: | 5165655816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2006 | ||||||||
| LastUpdateDate: | 05/03/2015 | ||||||||
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| AuthorizedOfficialLastName: | PHILIPSON | ||||||||
| AuthorizedOfficialFirstName: | BEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 5168693700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 2950318N | NY | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 2950318N | 01 | NY | OPERATING PROVIDER NUMBER | OTHER | 6050 | 01 | NY | PRIM FACILITY INDICATOR | OTHER | 01701651 | 05 | NY | MEDICAID |