Basic Information
| Provider Information | |||||||||
| NPI: | 1831649268 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DOWN EAST LIVING & REHAB CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14C 53RD ST | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112322644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185670400 | ||||||||
| FaxNumber: | 7185670600 | ||||||||
| Practice Location | |||||||||
| Address1: | 38 CARTERS RD | ||||||||
| Address2: | |||||||||
| City: | GATESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279389302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185670400 | ||||||||
| FaxNumber: | 7185670600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2016 | ||||||||
| LastUpdateDate: | 12/12/2017 | ||||||||
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| AuthorizedOfficialLastName: | STERN | ||||||||
| AuthorizedOfficialFirstName: | SAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 7185670400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 311ZA0620X | NH0513 | NC | N | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | 385H00000X | N | Respite Care Facility | Respite Care | 314000000X | NH0513 | NC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.