Provider Demographics
NPI:1902892359
Name:STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE LLC
Entity Type:Organization
Organization Name:STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE LLC
Other - Org Name:DELAIRE NURSING AND CONV. CTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LNHA
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PILEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-862-3399
Mailing Address - Street 1:400 W STIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4434
Mailing Address - Country:US
Mailing Address - Phone:908-862-3399
Mailing Address - Fax:
Practice Address - Street 1:400 W STIMPSON AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4434
Practice Address - Country:US
Practice Address - Phone:908-862-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ062017314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60009731OtherHORIZON NJ HEALTH
NJ92649OtherAMERICAID
NJ0033626Medicaid
NJ4422127OtherAETNA (TRADITIONAL)
NJ315200OtherHORIZON BC/BS (SKILLED)
NJUN000012000OtherAMERICHOICE
NJ4504909Medicaid
NJ2884135OtherAETNA (HMO)
NJA420707OtherOXFORD
NJ001162OtherHORIZON BC/BS (SUBACUTE)
NJ12243OtherWELLCHOICE OF NJ
NJ0033626Medicaid
NJ4422127OtherAETNA (TRADITIONAL)