Basic Information
| Provider Information | |||||||||
| NPI: | 1386708667 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VIRTUA HEALTH & REHABILITATION CENTER AT MOUNT HOLLY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 62 RICHMOND AVE | ||||||||
| Address2: | |||||||||
| City: | LUMBERTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080481632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092678800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 62 RICHMOND AVE | ||||||||
| Address2: | |||||||||
| City: | LUMBERTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080481632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092678800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | COHEN | ||||||||
| AuthorizedOfficialFirstName: | SHEILA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8563223603 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 060310 | NJ | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.