MEDICARE: CL HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1336537232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CL HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	100 ROUTE 70
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-7406
Country	:	US
Telephone Number	:	732-659-1353
Fax Number	:	866-306-0259

Provider Business Practice Location Address
First Line	:	102 E SILVER ST
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-1812
Country	:	US
Telephone Number	:	513-932-0300
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JACOB S STERN
Credential	:
Telephone Number	:	732-659-1353

Provider Enumeration Date	:	12/30/2014
Last Update Date	:	01/02/2015

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Directions to “CL HEALTHCARE, LLC ” Practice Location

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