Basic Information
| Provider Information | |||||||||
| NPI: | 1922583657 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTSVILLE TN OPCO LLC | ||||||||
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| OtherOrganizationName: | HUNTSVILLE HEALTH AND REHAILITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2071 FLATBUSH AVE STE 12 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112344340 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 287 BAKER ST | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377563444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738707818 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2018 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOSKOWITZ | ||||||||
| AuthorizedOfficialFirstName: | ISAAC | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6466491131 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.