Garden State Nursing Home Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060704 Issued in NJ

Legal business name

GARDEN STATE NURSING HOME INC.

Practice address

101 N Grove St
East Orange, NJ 07017-4712

Phone

(973) 672-1700

Fax

(973) 672-7854

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Joseph D. Cohen

Title

Administrator

Phone

(973) 672-1700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• New Grove Manor Doing business as

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1811983166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N GROVE ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070174712",
            "telephone_number": "973-672-1700",
            "fax_number": "973-672-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N GROVE ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070174712",
            "telephone_number": "973-672-1700",
            "fax_number": "973-672-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE NURSING HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "973-672-1700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNYSIS",
            "identifier": "4475500",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07090",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Grove Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melania Garcesto, RN
• Foster Garcia, LCSW
• Leslie Nicole Garcia
• Lydia N Garcia
• Yulidanny Garcia
• Garner Anesthesia LLC
• Sakinah Garrett-Corcoran
• Rhonda Elysia Garrett, RN
• Tanya Gaskins
• Christopher Bradford Gates, PHD

• All providers in East Orange, NJ
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.