1165 Easton Avenue Operations LLC

Organization Active NPI Nursing Facility/Intermediate Care Facility · Somerset, NJ

NPI 1528577293 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1528577293
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
00000 (NJ)
Legal business name
1165 EASTON AVENUE OPERATIONS LLC
Practice address
1165 Easton Ave
Somerset, NJ 08873-1613
Phone
(732) 246-4100
NPI assigned
Sep 26, 2017
Organization subpart
No

Authorized official

Name
Michael T Berg
Title
VP Gen Counsel Asst Secy
Phone
(505) 468-4742

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 00000 NJ Yes

Addresses

Primary practice location

1165 Easton Ave
Somerset, NJ 08873-1613

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
00000OtherNJNON MEDICARE

Other names

  • WILLOW CREEK REHABILITATION CARE CENTER Doing business as

Other providers in Somerset, NJ

All providers in Somerset, NJ · Nursing Facility/Intermediate Care Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.