Provider Demographics
NPI:1023181666
Name:BACHARACH INSTITUTE FOR REHABILITATION, INC.
Entity Type:Organization
Organization Name:BACHARACH INSTITUTE FOR REHABILITATION, INC.
Other - Org Name:RENNAISSANCE PAVILION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:CPAM
Authorized Official - Phone:609-748-5454
Mailing Address - Street 1:61 W JIMMIE LEEDS ROAD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240-0723
Mailing Address - Country:US
Mailing Address - Phone:609-652-7000
Mailing Address - Fax:609-748-7755
Practice Address - Street 1:61 W JIMMIE LEEDS ROAD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240-0723
Practice Address - Country:US
Practice Address - Phone:609-652-7000
Practice Address - Fax:609-748-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ018251314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315495Medicare ID - Type Unspecified