Basic Information
| Provider Information | |||||||||
| NPI: | 1811546955 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CANTERBURY OPERATOR LLC | ||||||||
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| OtherOrganizationName: | CANTERBURY REHABILITATION AND HEALTHCARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608 ROUTE 88 | ||||||||
| Address2: | |||||||||
| City: | BRICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087243009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329031958 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1776 CAMBRIDGE DR | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232383203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047406174 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2019 | ||||||||
| LastUpdateDate: | 01/06/2020 | ||||||||
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| AuthorizedOfficialLastName: | ROKOWSKY | ||||||||
| AuthorizedOfficialFirstName: | YITZCHOK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRINCIPLE | ||||||||
| AuthorizedOfficialTelephone: | 7329031958 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.