# VANGUARD OF CRESTWOOD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crestwood Nursing & Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790764256
- **Authorized official:** MR. KIRK F. HEBERT (FINANCIAL ANALYST)
- **Authorized official phone:** (615) 250-7100

## Contact information

- **Practice address:** 101 WHIPPANY RD, WHIPPANY, NJ 07981-1407
- **Practice address phone:** (973) 887-0311
- **Practice address fax:** (973) 887-8355
- **Mailing address:** 6 CADILLAC DR, SUITE 310, BRENTWOOD, TN 37027-5080
- **Mailing address phone:** (615) 250-7100
- **Mailing address fax:** (615) 250-7102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 061402 | NJ | Yes |

## Other

- **Enumeration date:** 01/12/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8938407 | — | NJ |