Victory Lake Operations, Llc

NPI 1164419511 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1164419511
Enumeration Date 09/30/2005
Last Updated 01/15/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name GERALD J GERALD
Position OPERATOR
Phone (845) 229-9177
Fax (845) 229-2734
Practice Location
419 N QUAKER LN
HYDE PARK NY, 12538-2933, US
Phone (845) 229-9177
Fax (845) 229-2734
Business Location
419 N QUAKER LN
HYDE PARK NY, 12538-2933, US
Phone (845) 229-9177
Fax (845) 229-2734
Toxanomy
Taxonomy Code 314000000X
License State New York
License Number 00308961
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According to our database, Victory Lake Operations, Llc NPI is 1164419511, taxonomy code is 314000000X and license number is 00308961, license state is located at New York. Victory Lake Operations, Llc physically located at 419 N Quaker Ln, Hyde Park NY, 12538-2933. NPI Number 1033115704 has the healthcare provider type.

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1164419511 NPI number is provided on an as is basis without warranty of any kind. 1164419511 is maintained by the National Plan & Provider Enumeration System. The contents of Victory Lake Operations, Llc are for informational purposes only.