Innova Gloucester Deptford Bridge Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

INNOVA GLOUCESTER DEPTFORD BRIDGE OPERATIONS LLC

Doing business as

Deptford Center for Rehabilitation & Healthcare

Practice address

1511 Clements Bridge Rd
Deptford, NJ 08096-3007

Phone

(718) 931-9700

NPI assigned

Dec 13, 2011

Last updated

Dec 31, 2019By 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

Mr. Daryl Hagler

Title

Member

Phone

(718) 931-9700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deptford Center for Rehabilitation & Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407124837. Details of each certification follow.

• CCN 315174 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 315174

Legal name

INNOVA GLOUCESTER DEPTFORD BRIDGE OPERATIONS LLC

Doing business as

DEPTFORD CENTER FOR REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 21, 1980

Last certification

Mar 5, 2024

Beds

240

Ownership / control type

Corporation

Multi-facility organization

Centers Health Care

Organization structure

LLCProprietary

Incorporated

Aug 11, 2011 in NJ

Enrollment address

1511 Clements Bridge Road
Deptford Center for Rehabilitation and Healthcare
Debtford, NJ 08096-3007

Nursing home name

DEPTFORD CENTER FOR REHABILITATION AND HEALTHCARE

Affiliated entity

CENTERS HEALTH CARE

Listed as

Deptford Center for Rehabilitation and HealthcareCCN 315174 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Feb 21, 1980

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

240226.7 residents per day on average

Chain

Centers Health Care36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Joseph J. Conti, D.O.

  • Internal Medicine Physician
  • Laurel Springs, NJ
  • NPI 1679552921

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ahsan A Abdulghani, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Turnersville, NJ
  • NPI 1881670891
  NPD (past)
• Joseph J. Conti, D.O.

  • Internal Medicine Physician
  • Laurel Springs, NJ
  • NPI 1679552921
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ahsan A Abdulghani, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Turnersville, NJ
  • NPI 1881670891

  Nursing home

  Care Compare affiliation
• Joseph J. Conti, D.O.

  • Internal Medicine Physician
  • Laurel Springs, NJ
  • NPI 1679552921

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1407124837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701104",
            "telephone_number": "718-931-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 CLEMENTS BRIDGE RD",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080963007",
            "telephone_number": "718-931-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA GLOUCESTER DEPTFORD BRIDGE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "HAGLER",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-931-9700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04478207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deptford Center for Rehabilitation & Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Deptford, NJ
• Providers in Deptford, 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 Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.