Healthcare Provider Details

I. General information

NPI: 1699410654
Provider Name (Legal Business Name): MOUNTAINVIEW REHABILITATION AND NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 STAFFORD AVE
SCRANTON PA
18505-3686
US

IV. Provider business mailing address

180 SYLVAN AVE STE 202
ENGLEWOOD CLIFFS NJ
07632-2512
US

V. Phone/Fax

Practice location:
  • Phone: 516-507-8465
  • Fax:
Mailing address:
  • Phone: 718-570-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DANIEL MANDELBAUM
Title or Position: CFO
Credential:
Phone: 718-570-6018