Healthcare Provider Details

I. General information

NPI: 1891587119
Provider Name (Legal Business Name): ENCORE AT WEST MEADOW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 POSSUM PARK RD
NEWARK DE
19711-3877
US

IV. Provider business mailing address

120 CRAFT AVE
INWOOD NY
11096-1708
US

V. Phone/Fax

Practice location:
  • Phone: 646-285-5701
  • Fax:
Mailing address:
  • Phone: 732-674-3498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: HARRY BARAX
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 646-285-5701