Basic Information
| Provider Information | |||||||||
| NPI: | 1255007639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHORE GARDENS REHABILITATION AND NURSING CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 231 WARNER ST | ||||||||
| Address2: | |||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087551028 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 231 WARNER ST | ||||||||
| Address2: | |||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087551028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329420800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2021 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | ABRAMCZYK | ||||||||
| AuthorizedOfficialFirstName: | NAFTOLI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATOR | ||||||||
| AuthorizedOfficialTelephone: | 3472543569 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.