Healthcare Provider Details

I. General information

NPI: 1306572474
Provider Name (Legal Business Name): BROOKHAVEN CENTER FOR REHABILITATION AND HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PARK END PL
EAST ORANGE NJ
07018-1116
US

IV. Provider business mailing address

211 BOULEVARD OF THE AMERICAS SUITE 209
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 732-952-3943
  • Fax:
Mailing address:
  • Phone: 732-352-3943
  • 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: MR. ABRAHAM KRAUS
Title or Position: MEMBER
Credential:
Phone: 732-352-3943