Complete Care at Willow Creek LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

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

Last updated

Apr 22, 2020By 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

Shalom Stein

Title

Owner

Phone

(732) 966-3091

Specialties & licenses 1

Addresses

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": "1295355055",
    "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.