Healthcare Provider Details

I. General information

NPI: 1043370596
Provider Name (Legal Business Name): LAUREL BAY HEALTH AND REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 LAUREL AVE
KEANSBURG NJ
07734-1125
US

IV. Provider business mailing address

32 LAUREL AVE
KEANSBURG NJ
07734-1125
US

V. Phone/Fax

Practice location:
  • Phone: 732-787-8100
  • Fax: 732-787-9042
Mailing address:
  • Phone: 732-787-8100
  • Fax: 732-787-9042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061333
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID DENNIN
Title or Position: CFO
Credential:
Phone: 732-787-8100