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33D2029667 CLIA NUMBER - PROVIDENCE REST NURSING HOME

Laboratory Demographics

CLIA Number: 33D2029667

Facility Name: PROVIDENCE REST NURSING HOME

Facility Address:
3304 WATERBURY AVENUE
BRONX, NY
ZIP 10465
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Facility Phone Number: 718 931-3000

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1871754861

Taxonomy: 314000000X - 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.

CLIA Record

Field Name Field Value
CLIA Number 33D2029667
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PROVIDENCE REST NURSING HOME
Street 3304 WATERBURY AVENUE
City BRONX
State NY
ZIP 10465
Phone 718 931-3000
CertificateType 4
CertificateEffectiveDate 9/13/2011
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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This page was last updated on: 4/23/2024