# INNOVA BURLINGTON CHURCH OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mount Laurel Center for Rehabilitation & Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851669287
- **Authorized official:** MR. DARYL HAGLER (MEMBER)
- **Authorized official phone:** (718) 931-9700

## Contact information

- **Practice address:** 3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
- **Practice address phone:** (856) 235-7100
- **Mailing address:** 4770 WHITE PLAINS RD, BRONX, NY 10470-1104
- **Mailing address phone:** (718) 931-9700

## Taxonomy

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

## Other

- **Enumeration date:** 12/13/2011
- **Last updated:** 02/22/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04465903 | — | NJ |