# LINCOLN PARK RENAISSANCE REHAB. & NURSING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730142423
- **Authorized official:** MRS. MIMI FELICIANO (CEO)
- **Authorized official phone:** (973) 696-3300

## Contact information

- **Practice address:** 499 PINE BROOK RD, LINCOLN PARK, NJ 07035-1804
- **Practice address phone:** (973) 696-3300
- **Practice address fax:** (973) 633-8747
- **Mailing address:** 499 PINE BROOK RD, LINCOLN PARK, NJ 07035-1804
- **Mailing address phone:** (973) 696-3300
- **Mailing address fax:** (973) 633-8747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 061408 | NJ | Yes |

## Other

- **Enumeration date:** 04/11/2006
- **Last updated:** 11/26/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01216893 | — | NY |
| 05 | — | 4491904 | — | NJ |