Organization
MANOR CARE OF MOUNTAINSIDE NJ LLC
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Mountainside)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5743
Entity
Organization
Contact information
Practice address
1180 ROUTE 22, MOUNTAINSIDE, NJ 07092-2810
(908) 654-0020
(908) 654-8661
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
062021
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4506201
—
NJ
Enumeration date
06/11/2006
Last updated
01/24/2022
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