Healthcare Provider Details

I. General information

NPI: 1699237305
Provider Name (Legal Business Name): PARK RIDGE SNF AMOP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 12/31/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NOYES DR
PARK RIDGE NJ
07656-1294
US

IV. Provider business mailing address

C/O SPRING HILLS LLC 26 MAIN STREET
EDISON NJ
08837
US

V. Phone/Fax

Practice location:
  • Phone: 201-505-1777
  • Fax:
Mailing address:
  • Phone: 732-582-0400
  • 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: GREGORY HOOK
Title or Position: EVP COMPLIANCE
Credential:
Phone: 201-953-0546