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Organization
CHURCH HEALTH CARE, LLC
Active
Organization
CHURCH HEALTH CARE, LLC
Active
Other names
Innova Health and Rehab at Mt. Laurel
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH F MANCUSO (REGIONAL FINANCIAL CONTROLLER)
(856) 912-8250
Entity
Organization
Contact information
Practice address
3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
(856) 235-7100
(856) 235-6813
Mailing address
3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
(856) 235-7100
(856) 235-6813
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060311
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4465903
—
NJ
Enumeration date
08/30/2006
Last updated
08/22/2020
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