MEDICARE: COMPLETE CARE AT HARBORAGE LLC

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

General Provider Information

NPI Number	:	1699499863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE CARE AT HARBORAGE LLC

Provider Business Mailing Address
First Line	:	7600 RIVER RD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6217
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 RIVER RD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6217
Country	:	US
Telephone Number	:	201-854-5400
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHALOM STEIN
Credential	:
Telephone Number	:	732-313-0880

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	05/01/2026

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