Active NPI
Harbour View Senior Living Corp
- Skilled Nursing Facility
- North Bergen, NJ
National Provider Identifier
1558070797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- HARBOUR VIEW SENIOR LIVING CORP
- Practice address
- 3161 Kennedy Blvd
North Bergen, NJ 07047-2303 - Phone
- (201) 867-3585
- NPI assigned
- Nov 16, 2022
- 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
- Avraham Rosenberg
- Title
- Ceo
- Phone
- (732) 335-6949
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
3161 Kennedy Blvd
North Bergen, NJ 07047-2303
Mailing address
3505 Bergen Tpke
North Bergen, NJ 07047-2435
Phone (201) 867-3585
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Yes |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230309001112 | NJ | Part A Provider - Skilled Nursing Facility | 0244603421 | Practice locations: North Bergen, NJ |
Skilled nursing facility certification: CCN 315525
- Legal name
- HARBOUR VIEW SENIOR LIVING CORP
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 5, 2018
- Last certification
- Mar 5, 2024
- Beds
- 84
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Jul 1, 2022 in NJ
- Enrollment address
- 3161 Kennedy Blvd
North Bergen, NJ 07047-2303 - Nursing home name
- HARBOUR VIEW SENIOR LIVING CORP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Harbour View Senior Living Corp
- Overall star rating
- Health inspections
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 5, 2018
- Medicare certification status
- Active
- Certified beds
- 84
- Penalties (3 years)
- 1
National Provider Directory
National Provider Directory- Tax ID family
- Harbour View Senior Living Corp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- North Bergen, NJ
- NPI 1841014305
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Avraham Rosenberg | 5% Or Greater Mortgage Interest | Jul 1, 2022 | 100% |
| Rebecca Frey | Operational/Managerial Control | Apr 10, 2023 | |
| Adp of the SNF | Apr 10, 2023 | ||
| 3161 Kenney Blvd LLC | 5% Or Greater Mortgage Interest | Jul 1, 2022 | 100% |
| 5% Or Greater Security Interest | Jul 1, 2022 | 100% | |
| Adp of the SNF | Jul 1, 2022 | ||
| Samuel Stern | Corporate Officer | Jul 1, 2022 | |
| Libbi Mendelovitz | 5% Or Greater Direct Ownership Interest | Jul 1, 2022 | 100% |
| Marc Goldstein | Operational/Managerial Control | Jul 1, 2022 | |
| Adp of the SNF | Jul 1, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- North Bergen, NJ
- NPI 1770569568
Adp of the SNF, Operational/Managerial Control
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Assisted Living Facility
- North Bergen, NJ
- NPI 1841014305
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Toms River, NJ
- NPI 1619663044
-
- Family Medicine Physician
- North Bergen, NJ
- NPI 1770569568
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731283200000",
"number": "1558070797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3505 BERGEN TPKE",
"city": "NORTH BERGEN",
"state": "NJ",
"postal_code": "070472435",
"telephone_number": "201-867-3585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3161 KENNEDY BLVD",
"city": "NORTH BERGEN",
"state": "NJ",
"postal_code": "070472303",
"telephone_number": "201-867-3585"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HARBOUR VIEW SENIOR LIVING CORP",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-16",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A",
"authorized_official_last_name": "ROSENBERG",
"authorized_official_first_name": "AVRAHAM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "732-335-6949"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Yes",
"affiliation": "N",
"address_1": "3505 Bergen Tpke",
"city": "North Bergen",
"state": "NJ",
"country_code": "US",
"postal_code": "070472435",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in North Bergen, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.