# SKILES AVENUE AND STERLING DRIVE URBAN RENEWAL OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENESIS NJ HOLDINGS LLC
- **Other names:** POWERBACK REHABILITATION PISCATAWAY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598323099
- **Legal business name:** GENESIS NJ HOLDINGS LLC
- **Authorized official:** MICHAEL THEODORE BERG (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (505) 468-4742

## Contact information

- **Practice address:** 10 STERLING DR, PISCATAWAY, NJ 08854-4911
- **Practice address phone:** (732) 917-2900
- **Practice address fax:** (732) 917-2901
- **Mailing address:** 10 STERLING DR, PISCATAWAY, NJ 08854-4911
- **Mailing address phone:** (732) 917-2900
- **Mailing address fax:** (732) 917-2901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/31/2019
- **Last updated:** 05/31/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0600458 | — | NJ |
| 01 | — | 1821532946 | NPI FOR SNF | NJ |