Basic Information
Provider Information
NPI: 1275182313
EntityType: 2
ReplacementNPI:  
OrganizationName: WESTMORELAND OPERATOR LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: WESTMORELAND REHABILITATION AND HEALTHCARE CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1608 ROUTE 88
Address2:  
City: BRICK
State: NJ
PostalCode: 087243009
CountryCode: US
TelephoneNumber: 7329031958
FaxNumber:  
Practice Location
Address1: 2400 MCKINNEY BLVD
Address2:  
City: COLONIAL BEACH
State: VA
PostalCode: 224431237
CountryCode: US
TelephoneNumber: 8042242222
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/11/2019
LastUpdateDate: 01/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ROKOWSKY
AuthorizedOfficialFirstName: YITZCHOK
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRINCIPLE
AuthorizedOfficialTelephone: 7329031958
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X  Y Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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