Willow Creek Rehabilitation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

40QB00224700 Issued in NJ

Legal business name

WILLOW CREEK REHABILITATION

Practice address

51 Oak St FL 1
East Orange, NJ 07018-2823

Phone

(862) 215-9077

NPI assigned

Jun 22, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Susan McClone

Title

Rehab Director

Phone

(862) 215-9077

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Guerrier, PTA

  • Physical Therapy Assistant
  • Jersey City, NJ
  • NPI 1831706845
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1417210642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 OAK ST FL 1",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 OAK ST FL 1",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182823",
            "telephone_number": "862-215-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "MCCLONE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "REHAB DIRECTOR",
        "authorized_official_telephone_number": "862-215-9077",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "40QB00224700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leroy Williams Jr., D.D.S.
• Luci O Williams, RD
• Mia Williams
• Michaelangelo Aristotle Williams, D.P.M.
• Vinnette Fay Williams, M.A. CCC-SLP
• Windsor Gardens Adult Day Care
• Windsor Gardens Care Center
• Windsor Gardens Care Center, Inc.
• Winston J Scott
• Wisdoms Inventions

• Skilled Nursing Facility in East Orange, NJ
• Providers in East Orange, 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 Jun 22, 2012; 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.