CPL Park Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060716 Issued in NJ

Legal business name

CPL PARK MANOR LLC

Doing business as

Park Manor Nursing and Rehabilitation Center

Practice address

23 Park Place
Bloomfield, NJ 07003-3513

Phone

(973) 743-7772

Fax

(973) 743-8053

NPI assigned

Nov 10, 2005

Last updated

Jul 27, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carole M Scillia, LLC MANAGER

Title

Office Manager

Phone

(203) 608-6100

Specialties & licenses 1

Addresses

Other names 1

• Park Manor Nursing and Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1073594511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 PRESTON AVENUE",
            "address_2": "SUITE 270",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504851",
            "telephone_number": "203-608-6100",
            "fax_number": "203-639-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PARK PLACE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033513",
            "telephone_number": "973-743-7772",
            "fax_number": "973-743-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPL PARK MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "SCILLIA",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-608-6100",
        "authorized_official_credential": "LLC MANAGER"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Manor Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.