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Organization
PARK RIDGE HEALTHCARE SNF, LLC
Active
Organization
PARK RIDGE HEALTHCARE SNF, LLC
Active
Other names
The Plaza Regency at Park Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN MARTIN (LNHA)
(201) 505-1777
Entity
Organization
Contact information
Practice address
120 NOYES DR, PARK RIDGE, NJ 07656-1294
(201) 505-1777
Mailing address
120 NOYES DR, PARK RIDGE, NJ 07656-1294
(201) 505-1777
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
62219
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001006
HORIZON BC/BS (SUBACUTE)
NJ
01
—
108331
AMERICAID
NJ
01
—
18406
WELLCHOICE OF NJ
NJ
01
—
315438
HORIZON BC/BS (SKILLED)
NJ
01
—
3226705
AETNA (HMO)
NJ
01
—
60010170
HORIZON NJ HEALTH
NJ
01
—
7399349
AETNA (TRADITIONAL)
NJ
05
—
7667302
—
NJ
Enumeration date
09/21/2005
Last updated
08/22/2020
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