Organization
CLARK NURSING AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY SANTO LSW/LNHA (ADMINISTRATOR)
(732) 396-7100
Entity
Organization
Contact information
Practice address
1213 WESTFIELD AVE, CLARK, NJ 07066-1323
(732) 396-7100
Mailing address
1213 WESTFIELD AVE, CLARK, NJ 07066-1323
(732) 396-7100
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
062211
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6468209
—
NJ
01
—
6468217
VENTILATOR UNIT UNISYS #
NJ
Enumeration date
04/06/2006
Last updated
05/03/2012
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