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Organization
WANAQUE CONVALESCENT CENTER
Active
Organization
WANAQUE CONVALESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J SALL (CEO)
(856) 663-4044
Entity
Organization
Contact information
Practice address
1433 RINGWOOD AVE, HASKELL, NJ 07420-1520
(973) 839-2119
(973) 839-5155
Mailing address
1433 RINGWOOD AVE, HASKELL, NJ 07420-1520
(973) 839-2119
(973) 839-5155
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
061628
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01057345
—
NY
05
—
01292924
—
NY
05
—
4496001
—
NJ
Enumeration date
12/13/2006
Last updated
08/22/2020
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