Organization
803 HACIENDA LANE OPERATIONS LLC
Active
Other names
Bloomfield Nursing and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(610) 925-2254
Entity
Organization
Contact information
Practice address
803 HACIENDA LN, BLOOMFIELD, NM 87413-5109
(610) 925-2254
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-2254
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NM
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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