Basic Information
| Provider Information | |||||||||
| NPI: | 1982010310 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WESTGATE HILLS OPERATOR LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WESTGATE HILLS REHABILITATION AND HEALTHCARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 ROUTE 70 FL 2 | ||||||||
| Address2: | |||||||||
| City: | BRICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087234042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326065973 | ||||||||
| FaxNumber: | 7326082976 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 N ROCK GLEN RD | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212293250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106462100 | ||||||||
| FaxNumber: | 4106462112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2014 | ||||||||
| LastUpdateDate: | 07/07/2014 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ROKEACH | ||||||||
| AuthorizedOfficialFirstName: | NACHUM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7322329217 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | COO | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 30099 | MD | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.