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General NPI Number Information
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NPI Number | 1427057918
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Entity Type | Organization
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Legal Business Name | REGENCY HERITAGE NURSING & REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 380 DEMOTT LANE
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City | SOMERSET
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State | NJ
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Zip | 08873-2762
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Country | US
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Telephone | 732-873-2000
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Fax | 732-873-2112
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Provider Business Mailing Address
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Address Line | 643 CROSS ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4610
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Country | US
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Telephone | 732-730-9280
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Fax | 732-730-9278
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Authorized Official
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Title or Position | CONTROLLER
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Name | AARON STEFANSKY
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Credential |
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Telephone | 732-730-9280
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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 | 061801
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License Number State | NJ
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