# CHESTNUT HILL CONVALESCENT & REHABILITATION CENTER

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

## Provider details

- **NPI number:** 1831256411
- **Authorized official:** DR. GEORGE PECK JR. (BOARD MEMBER)
- **Authorized official phone:** (973) 777-7800

## Contact information

- **Practice address:** 360 CHESTNUT ST, PASSAIC, NJ 07055-3124
- **Practice address phone:** (973) 777-7800
- **Practice address fax:** (973) 778-9013
- **Mailing address:** 360 CHESTNUT ST, PASSAIC, NJ 07055-3124
- **Mailing address phone:** (973) 777-7800
- **Mailing address fax:** (973) 778-9013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 061605 | NJ | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 12/17/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 315085 | MEDICARE PROVIDER NUMBER | NJ |
| 05 | — | 4495900 | — | NJ |