Organization
PARK RIDGE HEALTHCARE SNF, LLC
Active
Other names
The Plaza Regency at Park Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN MARTIN (LNHA)
(201) 505-1777
Entity
Organization
Contact information
Practice address
120 NOYES DR, PARK RIDGE, NJ 07656-1294
(201) 505-1777
Mailing address
120 NOYES DR, PARK RIDGE, NJ 07656-1294
(201) 505-1777
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
62219
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001006
HORIZON BC/BS (SUBACUTE)
NJ
01
—
108331
AMERICAID
NJ
01
—
18406
WELLCHOICE OF NJ
NJ
01
—
315438
HORIZON BC/BS (SKILLED)
NJ
01
—
3226705
AETNA (HMO)
NJ
01
—
60010170
HORIZON NJ HEALTH
NJ
01
—
7399349
AETNA (TRADITIONAL)
NJ
05
—
7667302
—
NJ
Enumeration date
09/21/2005
Last updated
08/22/2020
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