CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC. (NPI# 1417952417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417952417 |
| Entity Type | Organization |
| Organization Name | CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC. |
| Practice Address |
25 Fanning St Staten Island NY 10314-5307 |
| Practice Telephone | 7182897900 |
| Practice Fax Number | 7182897028 |
| Mailing Telephone | 7182897900 |
| Mailing Fax Number | 7182897028 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2014-07-22 |
| Authorized Official Name | MS. LORRI ANN SCULLIN-SENK (ADMINISTRATOR) |
| Authorized Official Telephone | 7182897890 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 7004305N | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00309884 | 05 |
| Street Address |
25 FANNING ST |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-5307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134676588 | N/a | Clinic/Center | 25 Fanning St, Staten Island, NY 10314-5307 | 2016-09-01 |
| 1285038141 | Wuraola Ismaila | Registered Nurse | 25 Fanning St, Staten Island, NY 10314-5307 | 2014-10-21 |
| 1306086707 | Suma Mariam Kuriakose | Physical Therapist | 25 Fanning St, Staten Island, NY 10314-5307 | 2009-02-24 |
| 1750506853 | John Thomas | Physical Therapy Assistant | 25 Fanning St, Staten Island, NY 10314-5307 | 2007-04-16 |
| 1659314193 | Clove Lakes Rehabilitation and Outpatient Services | Speech-Language Pathologist | 25 Fanning St, Staten Island, NY 10314-5307 | 2006-06-13 |
| 1669453502 | Island Rehabilitative Services Corp | Clinic/Center | 25 Fanning St, Staten Island, NY 10314-5307 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915351 | Loretta Scott Inc | Skilled Nursing Facility | 99 Leverett Ave, Staten Island, NY 10308-1724 | 2014-09-18 |
| 1033200100 | Verrazano Nursing Home Inc | Skilled Nursing Facility | 100 Castleton Avenue, Staten Island, NY 10301 | 2006-09-27 |
| 1023097698 | Carmel Richmond Nursing Home, Inc. | Skilled Nursing Facility | 88 Old Town Road, Staten Island, NY 10304 | 2006-01-12 |
| 1447248273 | Staten Island Care Center | Skilled Nursing Facility | 200 Lafayette Ave, Staten Island, NY 10301-1219 | 2005-10-06 |
| 1174510648 | Golden Gate Rehabilitation & Health Care Center LLC | Skilled Nursing Facility | 191 Bradley Ave, Staten Island, NY 10314-5166 | 2005-09-30 |
| 1255327078 | Silver Lake Specialized | Skilled Nursing Facility | 275 Castleton Ave, Staten Island, NY 10301-2709 | 2005-09-27 |
| 1770578064 | Sisters of Charity Health Care Systems Nh Inc | Skilled Nursing Facility | 91 Tompkins Ave, Staten Island, NY 10304-2601 | 2005-09-13 |
| 1922451327 | Margret Ultra Home Care | Skilled Nursing Facility | 34 Beach St, Staten Island, NY 10304-2702 | 2016-07-20 |
| 1992102321 | Alexia Santana | Skilled Nursing Facility | 275 Castleton Ave, Bookkeeping Department, Staten Island, NY 10301-2709 | 2014-12-01 |
| 1689003782 | Jose F Romney Rn | Skilled Nursing Facility | 49 Hudson Pl, 1a, Staten Island, NY 10303-2626 | 2013-11-08 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.