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Organization
CLARK NURSING AND REHABILITATION CENTER, LLC
Active
Organization
CLARK NURSING AND REHABILITATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY SANTO (ADMINISTRATOR)
(732) 396-7100
Entity
Organization
Contact information
Practice address
1213 WESTFIELD AVE, CLARK, NJ 07066-1323
(732) 396-7100
(732) 396-1924
Mailing address
1213 WESTFIELD AVE, CLARK, NJ 07066-1323
(732) 396-7100
(732) 396-1924
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
062211
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6468209
—
NJ
01
—
6468217
VENTILATOR UNIT -MEDICAID (MOLINA) #
NJ
Enumeration date
03/29/2017
Last updated
03/29/2017
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