Healthcare Provider Details

I. General information

NPI: 1962988360
Provider Name (Legal Business Name): VERSAILLES REHABILITATION AND HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MARKER RD
VERSAILLES OH
45380-9494
US

IV. Provider business mailing address

14 OLIVER ST
LAKEWOOD NJ
08701-2339
US

V. Phone/Fax

Practice location:
  • Phone: 732-372-9636
  • 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

VIII. Authorized Official

Name: MOSHE WEINTRAUB
Title or Position: COO
Credential:
Phone: 732-372-9636