Organization Active NPI

Complete Care at Willow Creek LLC

  • Nursing Facility/Intermediate Care Facility
  • Somerset, NJ
National Provider Identifier
1124648993
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
COMPLETE CARE AT WILLOW CREEK LLC
Practice address
1165 Easton Ave
Somerset, NJ 08873-1613
Phone
(732) 246-4100
NPI assigned
Apr 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Shalom Stein
Title
Owner
Phone
(732) 966-3091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

1165 Easton Ave
Somerset, NJ 08873-1613

Mailing address

1165 Easton Ave
Somerset, NJ 08873-1613
Phone (732) 246-4100

National Provider Directory

National Provider Directory

Locations

1165 Easton Ave
Somerset, NJ 08873
Phone (732) 246-4100

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1124648993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 EASTON AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731613",
            "telephone_number": "732-246-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 EASTON AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731613",
            "telephone_number": "732-246-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE AT WILLOW CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-966-3091"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.