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General NPI Number Information
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NPI Number | 1104965615
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Entity Type | Organization
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Legal Business Name | JEWISH HOME AT ROCKLEIGH
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 10 LINK DR
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City | ROCKLEIGH
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State | NJ
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Zip | 07647-2504
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Country | US
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Telephone | 201-784-1414
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Fax | 201-750-4266
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Provider Business Mailing Address
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Address Line | 10 LINK DR
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City | ROCKLEIGH
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State | NJ
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Zip | 07647-2504
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Country | US
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Telephone | 201-784-1414
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Fax | 201-750-4266
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MRS. SUNNI HERMAN
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Credential |
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Telephone | 201-750-4236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | JZ24OP
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License Number State | NJ
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