Basic Information
Provider Information
NPI: 1588963326
EntityType: 2
ReplacementNPI:  
OrganizationName: JBRNC LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: JULIE BLAIR NURSING & REHABILITATION CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HILLCREST CTR STE 225
Address2:  
City: SPRING VALLEY
State: NY
PostalCode: 109773740
CountryCode: US
TelephoneNumber: 8453718100
FaxNumber: 8453710010
Practice Location
Address1: 325 NORTHERN BLVD
Address2:  
City: ALBANY
State: NY
PostalCode: 122041001
CountryCode: US
TelephoneNumber: 5184491100
FaxNumber: 5184490062
Other Information
ProviderEnumerationDate: 03/18/2011
LastUpdateDate: 03/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STEIF
AuthorizedOfficialFirstName: EFRAIM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MEMBER
AuthorizedOfficialTelephone: 8453718100
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X0101314NNYY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


Home