Woodhaven Nursing Home

LBN: Jbg Holding Company Llc
Woodhaven Nursing Home is an health care organization with primary practice located at 1360 Route 112 , Port Jefferson Station NY 11776-3078. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Jbg Holding Company Llc can be contacted via phone (631) 473-7100, or through Gaul, Kenneth via phone (631) 473-7100.

Contact Information

Primary practice address
1360 Route 112 Port Jefferson Station NY 11776-3078
Phone: (631) 473-7100
Fax: (631) 473-7118
Website:
Map and Directions
Authorized official contact:
Name: Gaul, Kenneth
Phone: (631) 473-7100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 5151316N New York

Profile Details

NPI number 1568459279
LBN Legal business name Jbg Holding Company Llc
DBA Doing business as Woodhaven Nursing Home
Authorized official Gaul, Kenneth
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2005
Last updated Feb 24th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568459279 NPPES
New York MEDICAID 00308470
New York Other 5151316N

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