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General NPI Number Information
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NPI Number | 1245235811
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Entity Type | Organization
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Legal Business Name | LIVINGSTON CARE CENTER
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 311 S LIVINGSTON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3927
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Country | US
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Telephone | 973-994-0221
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Fax | 973-992-0696
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Provider Business Mailing Address
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Address Line | 311 S LIVINGSTON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3927
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Country | US
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Telephone | 973-994-0221
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Fax | 973-992-0696
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEVE IZZO
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Credential |
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Telephone | 973-994-1049
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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 | 060708
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License Number State | NJ
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