Provider Demographics
NPI:1902499379
Name:JERSEY SHORE POST ACUTE REHABILITATION AND NURSING LLC
Entity Type:Organization
Organization Name:JERSEY SHORE POST ACUTE REHABILITATION AND NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-813-0030
Mailing Address - Street 1:1613 ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3000
Mailing Address - Country:US
Mailing Address - Phone:732-813-0030
Mailing Address - Fax:
Practice Address - Street 1:101 WALNUT ST
Practice Address - Street 2:
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753-4301
Practice Address - Country:US
Practice Address - Phone:732-813-6267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility