Healthcare Provider Details

I. General information

NPI: 1780304337
Provider Name (Legal Business Name): SOUTH KINGSTOWN NURSING & REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY PLAZA DR STE 303
HACKENSACK NJ
07601-6229
US

IV. Provider business mailing address

2115 S COUNTY TRL
WEST KINGSTON RI
02892-1634
US

V. Phone/Fax

Practice location:
  • Phone: 201-975-4400
  • 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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JONATHAN STRAUSS
Title or Position: OWNER/MANAGER
Credential:
Phone: 201-975-4400