Organization
INNOVA GLOUCESTER DEPTFORD BRIDGE OPERATIONS LLC
Active
Other names
Deptford Center for Rehabilitation & Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYL HAGLER (MEMBER)
(718) 931-9700
Entity
Organization
Contact information
Practice address
1511 CLEMENTS BRIDGE RD, DEPTFORD, NJ 08096-3007
(718) 931-9700
Mailing address
4770 WHITE PLAINS RD, BRONX, NY 10470-1104
(718) 931-9700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04478207
—
NJ
Enumeration date
12/13/2011
Last updated
12/31/2019
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