Organization
LEISURE CHATEAU ACQUISITION LLC
Active
Other names
Leisure Chateau Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN ROKEACH LNHA (ADMINISTRATOR)
(732) 370-8600
Entity
Organization
Contact information
Practice address
962 RIVER AVE, LAKEWOOD, NJ 08701-5605
(732) 370-8600
(732) 370-8676
Mailing address
962 RIVER AVE, LAKEWOOD, NJ 08701-5605
(732) 370-8600
(732) 370-8676
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
061515
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4493605
—
NJ
01
—
5952870001
MEDICARE NHIC
NJ
Enumeration date
09/30/2005
Last updated
04/12/2010
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