# HW WEIDCO REN LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Jersey Extended Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720096035
- **Authorized official:** MARK WEISZ (MEMBER)
- **Authorized official phone:** (201) 488-6789

## Contact information

- **Practice address:** 99 MANHEIM AVE, BRIDGETON, NJ 08302-2114
- **Practice address phone:** (856) 455-2100
- **Practice address fax:** (856) 455-0960
- **Mailing address:** 1 UNIVERSITY PLZ, SUITE 206, HACKENSACK, NJ 07601-6201
- **Mailing address phone:** (201) 488-6789
- **Mailing address fax:** (201) 488-7734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060602 | NJ | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 12/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4473701 | — | NJ |