Organization
LAKEVIEW SUBACUTE CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD FRANK GROSSO JR. LNHA (ADMINISTRATOR)
(973) 616-5815
Entity
Organization
Contact information
Practice address
130 TERHUNE DR, WAYNE, NJ 07470-7104
(973) 616-5815
(973) 616-2768
Mailing address
130 TERHUNE DR, WAYNE, NJ 07470-7104
(973) 616-5815
(973) 616-2768
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
61610
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047847
AETNA USHC
—
01
—
315110
BLUE CROSS BLUE SHIELD
NJ
05
—
4496205
—
NJ
01
—
4552
AMERIHEALTH
—
01
—
92624
AMERIGROUP
—
01
—
ANC268
OXFORD HEALTH
—
01
—
CV09616
CIGNA
—
Enumeration date
03/29/2007
Last updated
08/22/2020
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