Provider Demographics
NPI:1043048044
Name:MANSFIELD ACQUISITION OPERATOR LLC
Entity type:Organization
Organization Name:MANSFIELD ACQUISITION OPERATOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-705-4803
Mailing Address - Street 1:20 E SUNRISE HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1257
Mailing Address - Country:US
Mailing Address - Phone:516-705-4815
Mailing Address - Fax:516-887-8494
Practice Address - Street 1:100 WARREN CIR
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-2074
Practice Address - Country:US
Practice Address - Phone:860-487-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility