Basic Information
Provider Information
NPI: 1740787100
EntityType: 2
ReplacementNPI:  
OrganizationName: ORCHARD HILL OPERATOR LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ORCHARD HILL REHABILITATION AND HEALTHCARE CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 635 DUQUESNE BLVD
Address2:  
City: BRICK
State: NJ
PostalCode: 087235073
CountryCode: US
TelephoneNumber: 7329031958
FaxNumber:  
Practice Location
Address1: 111 WEST RD
Address2:  
City: TOWSON
State: MD
PostalCode: 212042315
CountryCode: US
TelephoneNumber: 7329031958
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/11/2018
LastUpdateDate: 04/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: POSEN
AuthorizedOfficialFirstName: MINDEE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: AUTHORIZED REPRESENTATIVE
AuthorizedOfficialTelephone: 7329031958
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2021

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

No ID Information.


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