Healthcare Provider Details

I. General information

NPI: 1750114880
Provider Name (Legal Business Name): NEW MARK OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11221 N NASHUA DR
KANSAS CITY MO
64155-1159
US

IV. Provider business mailing address

311 BLVD OF THE AMERICAS SUITE 201
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 816-734-4433
  • Fax:
Mailing address:
  • Phone:
  • 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: JACQUES WOLF
Title or Position: MANAGER
Credential:
Phone: 908-430-5100