# CHURCH HEALTH CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Innova Health and Rehab at Mt. Laurel
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699885129
- **Authorized official:** MR. JOSEPH F MANCUSO (REGIONAL FINANCIAL CONTROLLER)
- **Authorized official phone:** (856) 912-8250

## Contact information

- **Practice address:** 3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
- **Practice address phone:** (856) 235-7100
- **Practice address fax:** (856) 235-6813
- **Mailing address:** 3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
- **Mailing address phone:** (856) 235-7100
- **Mailing address fax:** (856) 235-6813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060311 | NJ | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4465903 | — | NJ |