Organization
LEISURE CHATEAU REHAB HUNTINGTONS DISEASE
Active
Parent organization
LEISURE CHATEAU ACQUISITION LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEISURE CHATEAU ACQUISITION LLC
Authorized official
MR. SHIMON FALIK (DIRECTOR)
(732) 370-8600
Entity
Organization
Contact information
Practice address
962 RIVER AVE, LAKEWOOD, NJ 08701-5605
(732) 370-8600
Mailing address
962 RIVER AVE, LAKEWOOD, NJ 08701-5605
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061515
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516082
—
NJ
Enumeration date
12/16/2016
Last updated
12/16/2016
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