Healthcare Provider Details

I. General information

NPI: 1700657772
Provider Name (Legal Business Name): MOUNTAINSIDE NURSING AND REHAB BHC OPERATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 ROUTE 22
MOUNTAINSIDE NJ
07092-2810
US

IV. Provider business mailing address

701 CROSS ST STE 132
LAKEWOOD NJ
08701-4029
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-0020
  • Fax:
Mailing address:
  • Phone: 908-654-0020
  • 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: MOSHE STEINBERG
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 908-654-0020