Healthcare Provider Details

I. General information

NPI: 1457720112
Provider Name (Legal Business Name): HALLMARK CARE AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 ROCKDALE AVE
NEW BEDFORD MA
02740-2947
US

IV. Provider business mailing address

505 MARLBORO RD
WOOD RIDGE NJ
07075-1235
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-7448
  • Fax:
Mailing address:
  • Phone: 201-635-1195
  • 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: BRANDON AUGUSTYNIAK
Title or Position: CFO
Credential:
Phone: 201-635-1195