Active NPI
Complete Care at Willow Creek LLC
- Nursing Facility/Intermediate Care Facility
- Somerset, NJ
National Provider Identifier
1124648993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.