Healthcare Provider Details

I. General information

NPI: 1205194230
Provider Name (Legal Business Name): BELMAR HEALTHCARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 JERSEY ST
TRENTON NJ
08611-3113
US

IV. Provider business mailing address

325 JERSEY ST
TRENTON NJ
08611-3113
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-3400
  • Fax:
Mailing address:
  • Phone: 609-394-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061112
License Number StateNJ

VIII. Authorized Official

Name: MR. EUGENE EHRENFELD
Title or Position: MEMBER
Credential: LNHA
Phone: 718-755-4047