# JEWISH HOME AT ROCKLEIGH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104965615
- **Authorized official:** MRS. SUNNI HERMAN (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (201) 750-4236

## Contact information

- **Practice address:** 10 LINK DR, ROCKLEIGH, NJ 07647-2504
- **Practice address phone:** (201) 784-1414
- **Practice address fax:** (201) 750-4266
- **Mailing address:** 10 LINK DR, ROCKLEIGH, NJ 07647-2504
- **Mailing address phone:** (201) 784-1414
- **Mailing address fax:** (201) 750-4266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | JZ24OP | NJ | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 09/10/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 025304 | WELLCOICE NEW JERSEY ID | NJ |
| 01 | — | 3223879 | AETNA HMO ID | NJ |
| 01 | — | 7773498 | AETNA PPO ID | NJ |
| 05 | — | 8749001 | — | NJ |