Healthcare Provider Details

I. General information

NPI: 1982010310
Provider Name (Legal Business Name): WESTGATE HILLS OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N ROCK GLEN RD
BALTIMORE MD
21229-3250
US

IV. Provider business mailing address

575 ROUTE 70 FL 2
BRICK NJ
08723-4042
US

V. Phone/Fax

Practice location:
  • Phone: 410-646-2100
  • Fax: 410-646-2112
Mailing address:
  • Phone: 732-606-5973
  • Fax: 732-608-2976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number30099
License Number StateMD

VIII. Authorized Official

Name: MR. NACHUM ROKEACH
Title or Position: CHIEF OPERATING OFFICER
Credential: COO
Phone: 732-232-9217