MEDICARE: BROOKHAVEN HEALTH CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	060732	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407956451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKHAVEN HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	2029 MORRIS AVE
Second Line	:	SUITE #2
City	:	UNION
State	:	NJ
Zip	:	07083-6013
Country	:	US
Telephone Number	:	908-686-3233
Fax Number	:	908-686-3668

Provider Business Practice Location Address
First Line	:	120 PARK END PL
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-1116
Country	:	US
Telephone Number	:	973-676-6221
Fax Number	:

Authorized Official
Title or Position	:	CONTRACT MANAGER
Name	:	MRS. MELISSA B LINTEAU
Credential	:
Telephone Number	:	908-686-3233

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/22/2020

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