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Organization
MANOR CARE OF MOUNTAINSIDE NJ LLC
Active
Organization
MANOR CARE OF MOUNTAINSIDE NJ LLC
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Mountainside)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5743
Entity
Organization
Contact information
Practice address
1180 ROUTE 22, MOUNTAINSIDE, NJ 07092-2810
(908) 654-0020
(908) 654-8661
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
062021
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4506201
—
NJ
Enumeration date
06/11/2006
Last updated
01/24/2022
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