Organization
HW WEIDCO REN LLC
Active
Other names
South Jersey Extended Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WEISZ (MEMBER)
(201) 488-6789
Entity
Organization
Contact information
Practice address
99 MANHEIM AVE, BRIDGETON, NJ 08302-2114
(856) 455-2100
(856) 455-0960
Mailing address
1 UNIVERSITY PLZ, SUITE 206, HACKENSACK, NJ 07601-6201
(201) 488-6789
(201) 488-7734
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060602
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4473701
—
NJ
Enumeration date
08/03/2006
Last updated
12/12/2008
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