MEDICARE: STRATEGIC LONG TERM CARE OF NJ AT BERKELEY HEIGHTS

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	062016	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01000355700	OTHER	NJ	AMERICHOICE
2	4422128	OTHER	NJ	4422128
3	92651	OTHER	NJ	AMERICAID
4	2884136	OTHER	NJ	AETNA (HMO)
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0013121	OTHER	NJ	HORIZON BC/BS (SUBACUTE)
7	60010169	OTHER	NJ	HORIZON NJ HEALTH
8	315195	OTHER	NJ	HORIZON BC/BS (SKILLED)

General Provider Information

NPI Number	:	1982690335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATEGIC LONG TERM CARE OF NJ AT BERKELEY HEIGHTS

Provider Business Mailing Address
First Line	:	35 COTTAGE ST
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1508
Country	:	US
Telephone Number	:	908-464-0048
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 COTTAGE ST
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1508
Country	:	US
Telephone Number	:	908-464-0048
Fax Number	:

Authorized Official
Title or Position	:	LNHA
Name	:	MARINA FERRER
Credential	:
Telephone Number	:	908-464-0048

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	02/25/2014

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