# STRATFORD MANOR REHABILITATION AND CARE CENTER LLC

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

## Provider details

- **NPI number:** 1912276882
- **Authorized official:** MR. THEODORE MIRKHANI LNHA, MBA (LLC MEMBER)
- **Authorized official phone:** (201) 232-3905

## Contact information

- **Practice address:** 787 NORTHFIELD AVE, WEST ORANGE, NJ 07052-1131
- **Practice address phone:** (973) 731-4500
- **Mailing address:** 787 NORTHFIELD AVE, WEST ORANGE, NJ 07052-1131
- **Mailing address phone:** (201) 232-3905
- **Mailing address fax:** (201) 489-6021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060714 | NJ | Yes |

## Other

- **Enumeration date:** 12/22/2011
- **Last updated:** 06/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0293539 | — | NJ |