MEDICARE: PALISADES GENERAL CARE 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
1	314000000X	Skilled Nursing Facility	060907	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811994338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALISADES GENERAL CARE INC

Provider Business Mailing Address
First Line	:	7600 RIVER RD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6217
Country	:	US
Telephone Number	:	201-854-8873
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	:	201-854-8873
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. SHAWN RYAN
Credential	:
Telephone Number	:	201-854-8873

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/22/2020

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Directions to “PALISADES GENERAL CARE INC ” Practice Location

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