Organization
STRATFORD MANOR REHABILITATION AND CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE MIRKHANI LNHA, MBA (LLC MEMBER)
(201) 232-3905
Entity
Organization
Contact information
Practice address
787 NORTHFIELD AVE, WEST ORANGE, NJ 07052-1131
(973) 731-4500
Mailing address
787 NORTHFIELD AVE, WEST ORANGE, NJ 07052-1131
(201) 232-3905
(201) 489-6021
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060714
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293539
—
NJ
Enumeration date
12/22/2011
Last updated
06/20/2012
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