Organization
CHURCH HEALTH CARE, LLC
Active
Other names
Innova Health and Rehab at Mt. Laurel
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH F MANCUSO (REGIONAL FINANCIAL CONTROLLER)
(856) 912-8250
Entity
Organization
Contact information
Practice address
3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
(856) 235-7100
(856) 235-6813
Mailing address
3718 CHURCH RD, MOUNT LAUREL, NJ 08054-1104
(856) 235-7100
(856) 235-6813
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060311
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4465903
—
NJ
Enumeration date
08/30/2006
Last updated
08/22/2020
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