Healthcare Provider Details

I. General information

NPI: 1497650816
Provider Name (Legal Business Name): HERMITAGE REHABILITATION & HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2026
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CLARKSVILLE RD
HERMITAGE PA
16148-2954
US

IV. Provider business mailing address

229 ROUTE 70 FL 2
TOMS RIVER NJ
08755-1026
US

V. Phone/Fax

Practice location:
  • Phone: 724-981-6610
  • 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: SHAI BERDUGO
Title or Position: MEDICARE AUTHORIZED OFFICIAL
Credential:
Phone: 847-555-0107