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NPI Code Detail

MEDICARE: CEDAR CREST VILLAGE INC

MEDICARE: CEDAR CREST VILLAGE INC
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
1314000000XSkilled Nursing Facility60922NJ

General Provider Information

NPI Number : 1427015882
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR CREST VILLAGE INC
Provider Business Mailing Address
First Line : 1 CEDAR CREST VILLAGE DRIVE
Second Line : ATTN: EXECUTIVE DIRECTOR
City : POMPTON PLAINS
State : NJ
Zip : 07444-2100
Country : US
Telephone Number : 973-831-3500
Fax Number : 410-204-7237
Provider Business Practice Location Address
First Line : 4 CEDAR CREST VILLAGE DR
Second Line : ATTN: EXTENDED CARE ADMINISTRATOR
City : POMPTON PLAINS
State : NJ
Zip : 07444-2161
Country : US
Telephone Number : 973-831-3500
Fax Number : 410-204-7237
Authorized Official
Title or Position : ASSISTANT TREASURER
Name : CHRISTOPHER J RATHMANN
Credential :
Telephone Number : 410-402-2390
Provider Enumeration Date : 04/28/2006
Last Update Date : 01/16/2015

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Directions to “CEDAR CREST VILLAGE INC ” Practice Location

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