Basic Information
| Provider Information | |||||||||
| NPI: | 1306572474 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROOKHAVEN CENTER FOR REHABILITATION AND HEALTHCARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 BOULEVARD OF THE AMERICAS | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323523943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 PARK END PL | ||||||||
| Address2: | |||||||||
| City: | EAST ORANGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070181116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329523943 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2022 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| AuthorizedOfficialLastName: | KRAUS | ||||||||
| AuthorizedOfficialFirstName: | ABRAHAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7323523943 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.