Organization Active NPI

Leisure Chateau Rehab Huntingtons Disease

  • Skilled Nursing Facility
  • Lakewood, NJ
National Provider Identifier
1629512181
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
061515 Issued in NJ
Legal business name
LEISURE CHATEAU REHAB HUNTINGTONS DISEASE
Practice address
962 River Ave
Lakewood, NJ 08701-5605
Phone
(732) 370-8600
NPI assigned
Dec 16, 2016
Organization subpart
Yes
Parent organization
LEISURE CHATEAU ACQUISITION LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Authorized official

Name
Mr. Shimon Falik
Title
Director
Phone
(732) 370-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 061515 NJ Primary

Addresses

Primary practice location

962 River Ave
Lakewood, NJ 08701-5605

Mailing address

962 River Ave
Lakewood, NJ 08701-5605

Other identifiers 1

IdentifierTypeStateIssuer
0516082MedicaidNJ

National Provider Directory

National Provider Directory
Part of
Leisure Chateau Rehab Huntingtons Disease

Locations

926 River Ave
Lakewood, NJ 08701

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1629512181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015605",
            "telephone_number": "732-370-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE CHATEAU REHAB HUNTINGTONS DISEASE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEISURE CHATEAU ACQUISITION LLC",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "FALIK",
        "authorized_official_first_name": "SHIMON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-370-8600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "061515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0516082",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.