| Organization Name: | THE SOCIETY OF ST. JOHNLAND |
| NPI Number: | 1275991846 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL BARTOLOTTA (CFO) |
| Mailing Address: | 395 Sunken Meadow Rd Kings Park |
| State: | NY US |
| Postal Code: | 117541000 |
| Phone Number: | 6316632450 |
| Fax Number: | 6316632100 |
| NPI Enumeration Date: | 02/10/2016 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |